National Provider Identifier

Evander Conzel Russ, LPN

Evander Conzel Russ, LPN is listed in the NPPES registry with a primary specialty of Licensed Practical Nurse in Geneva, NY and a listed phone number of (585) 438-1089.

NPI 1457820631Geneva, NYLicensed Practical Nurse

Profile Overview

NPI
1457820631
Provider Type
Individual
Primary Specialty
Licensed Practical Nurse
Enumeration Date
November 17, 2018
Last Updated
November 17, 2018

Practice Location

  • 23 North Ave
  • Geneva, NY 14456-1127

Phone: (585) 438-1089

Specialties

  • Licensed Practical Nurse (164W00000X)
Full Record
NPI
1457820631
Entity Type
Individual
Last Name
Russ
First Name
Evander
Middle Name
Conzel
Credential
LPN
Mailing Street Address
23 North Ave
Mailing City
Geneva
Mailing State
NY
Mailing ZIP Code
14456-1127
Mailing Country
US
Mailing Phone
(585) 438-1089
Practice Street Address
23 North Ave
Practice City
Geneva
Practice State
NY
Practice ZIP Code
14456-1127
Practice Country
US
Practice Phone
(585) 438-1089
Enumeration Date
November 17, 2018
Last Updated
November 17, 2018
Sex
Male
Sole Proprietor
No
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Licensed Practical Nurse (164W00000X)