National Provider Identifier
Shannan R Russ, N.P.
Shannan R Russ, N.P. is listed in the NPPES registry with a primary specialty of Family Nurse Practitioner in Elmira, NY and a listed phone number of (607) 734-3968.
Profile Overview
- NPI
- 1457405144
- Provider Type
- Individual
- Primary Specialty
- Family Nurse Practitioner
- Enumeration Date
- January 22, 2007
- Last Updated
- March 20, 2025
Practice Location
- 1005 Walnut St
- Elmira, NY 14901-1007
Phone: (607) 734-3968
Specialties
- Family Nurse Practitioner (363LF0000X)
Full Record
- NPI
- 1457405144
- Entity Type
- Individual
- Last Name
- Russ
- First Name
- Shannan
- Middle Name
- R
- Credential
- N.P.
- Provider Other Last Name
- Hamilton
- Provider Other First Name
- Shannan
- Provider Other Middle Name
- R
- Provider Other Credential Text
- N.P.
- Provider Other Last Name Type Code
- 1
- Mailing Street Address
- 1005 Walnut St
- Mailing City
- Elmira
- Mailing State
- NY
- Mailing ZIP Code
- 14901-1007
- Mailing Country
- US
- Mailing Phone
- (607) 734-3968
- Mailing Fax
- (833) 450-5884
- Practice Street Address
- 1005 Walnut St
- Practice City
- Elmira
- Practice State
- NY
- Practice ZIP Code
- 14901-1007
- Practice Country
- US
- Practice Phone
- (607) 734-3968
- Practice Fax
- (833) 450-5884
- Enumeration Date
- January 22, 2007
- Last Updated
- March 20, 2025
- Sex
- Female
- Sole Proprietor
- No
- Certification Date
- March 20, 2025
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Family Nurse Practitioner (363LF0000X)
- Other Identifiers
- 02001921 (NY)