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SANDRA G RUSSELL FNP
NPI 1932219581
Nurse Practitioner - Family in Petal, MS

Active since August 30, 2006
15 PUMPING STATION RD, PETAL, MS 39465(601) 583-1559(601) 583-1573 Get Directions Write a Review

NPPES record last updated: July 20, 2020. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Jul 20, 2020, Jun 11, 2020, Feb 27, 2017 and 1 more (4 updates tracked since 2016).

About Sandra G Russell Fnp NPPES

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

SANDRA G RUSSELL FNP (NPI 1932219581) is an individual family provider in Petal, Mississippi, licensed in Mississippi (639834) and active in the NPI registry since August 2006.

NPPES Registry Identity

NPI1932219581
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NameSANDRA G RUSSELLCredential: FNP
Location Address15 PUMPING STATION RDPetal, MS 39465-8325
Mailing Address415 S 28th AveHattiesburg, MS 39401-7246 · (601) 583-1559 · Fax (601) 579-5240
Phone(601) 583-1559
Fax(601) 583-1573
Sole ProprietorNo
Enumeration DateAugust 30, 2006
Last NPPES UpdateJuly 20, 20204 updates tracked since enumeration
NPPES CertifiedJuly 20, 2020
✔ NPI 1932219581 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License✔ Licensed in MS · 639834
Also ListedNurse PractitionerTaxonomy 363L00000X · License R639834 (MS)
15 PUMPING STATION RD, Petal, MS 39465
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Other Identifiers 3

Medicaid1501891LA
Medicaid00117682MS
Other640507572KLMS · American Admin Group

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

HATTIESBURG CLINIC PA
Family Medicine
15 PUMPING STATION RD
PETAL, MS 39465
Forrest County (601) 583-1559

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 Sandra Russell's NPI number?

The NPI number for Sandra Russell is 1932219581. It was assigned to this individual provider in the NPPES registry on August 30, 2006.

Where is Sandra Russell located?

Sandra Russell practices at 15 Pumping Station Rd, Petal, MS 39465. The listed phone number is (601) 583-1559.

What is Sandra Russell's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

When was this NPI record last updated?

The NPPES record for Sandra Russell was last updated on July 20, 2020. NPI Profile syncs with the weekly NPPES data releases published by CMS.