Jacqueline Marie Russell, PMHNP-BC
NPI #1720673577 in Enterprise, Oregon
Provider Information
- NPI Number
- 1720673577
- Entity Type
- Individual
- Name
- Jacqueline Marie Russell, PMHNP-BC
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Nurse Practitioner - Psychiatric/Mental Health
- Credential
- PMHNP-BC
- Enumeration Date
- Mar 3, 2021
- Last Updated
- Mar 1, 2024
Practice Location
- Address
- 606 MEDICAL PKWY
- City
- Enterprise
- State
- Oregon
- ZIP Code
- 97828-5140
- Phone
- (541) 426-4524
Specialties & Taxonomy Codes
| Specialty |
|---|
| Nurse Practitioner - Psychiatric/Mental Health — Psychiatric/Mental Health |
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