JESSICA RUSSELL
NPI 1396192258
Licensed Practical Nurse in Waterford, MI

Q: What is Jessica Russell's NPI number?

The NPI number for Jessica Russell is 1396192258. It was assigned to this individual provider in the NPPES registry on May 20, 2016.

Q: What is Jessica Russell's specialty?

The primary specialty registered for this NPI is Licensed Practical Nurse with taxonomy code 164W00000X.

Q: When was this NPI record last updated?

The NPPES record for Jessica Russell was last updated on May 20, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since May 20, 2016

7712 LAKE RIDGE DR, WATERFORD, MI 48327(248) 505-7204 Get Directions Write a Review

NPPES record last updated: May 20, 2016. Verified against the NPPES registry weekly; last sync: September 06, 2026.

On this page

About Jessica Russell NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JESSICA RUSSELL (NPI 1396192258) is an individual licensed practical nurse in Waterford, Michigan, licensed in Michigan (4703109555) and active in the NPI registry since May 2016.

NPPES Registry Identity

NPI1396192258

Entity TypeIndividualFemale

Primary Taxonomy164W00000X

Provider Legal NameJESSICA RUSSELL

Location Address7712 LAKE RIDGE DRWaterford, MI 48327-4164

Mailing Address7712 Lake Ridge DrWaterford, MI 48327-4164 · (248) 505-7204

Phone(248) 505-7204

Sole ProprietorNo

Enumeration DateMay 20, 2016

✔ NPI 1396192258 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyLicensed Practical NurseNursing Service Providers

Taxonomy Code164W00000X

License✔ Licensed in MI · 4703109555

Definition

A licensed practical nurse with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required for certification as a Registered Nurse. Requirements for education, experience, licensure, and job responsibilities vary among the states.

7712 LAKE RIDGE DR, Waterford, MI 48327

Open in Google Maps ↗

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jessica Russell's NPI number?

The NPI number for Jessica Russell is 1396192258. It was assigned to this individual provider in the NPPES registry on May 20, 2016.

Where is Jessica Russell located?

Jessica Russell practices at 7712 Lake Ridge Dr, Waterford, MI 48327. The listed phone number is (248) 505-7204.

What is Jessica Russell's specialty?

The primary specialty registered for this NPI is Licensed Practical Nurse with taxonomy code 164W00000X.

When was this NPI record last updated?

The NPPES record for Jessica Russell was last updated on May 20, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.