National Provider Identifier
Stephanie Nicole Russell, AGPCNP
Stephanie Nicole Russell, AGPCNP is listed in the NPPES registry with a primary specialty of Nurse Practitioner in Elmira, NY and a listed phone number of (607) 873-1832.
Profile Overview
- NPI
- 1629598370
- Provider Type
- Individual
- Primary Specialty
- Nurse Practitioner
- Enumeration Date
- June 23, 2017
- Last Updated
- November 30, 2020
Practice Location
- 200 Madison Ave Ste 2D
- Elmira, NY 14901-3219
Phone: (607) 873-1832
Mailing Address
- 571 Saint Josephs Blvd Fl 2
- Elmira, NY 14901-3230
Specialties
- Nurse Practitioner (363L00000X)
Full Record
- NPI
- 1629598370
- Entity Type
- Individual
- Last Name
- Russell
- First Name
- Stephanie
- Middle Name
- Nicole
- Credential
- AGPCNP
- Provider Other Last Name
- Parker
- Provider Other First Name
- Stephanie
- Provider Other Middle Name
- Nicole
- Provider Other Last Name Type Code
- 1
- Mailing Street Address
- 571 Saint Josephs Blvd Fl 2
- Mailing City
- Elmira
- Mailing State
- NY
- Mailing ZIP Code
- 14901-3230
- Mailing Country
- US
- Mailing Phone
- (607) 271-2050
- Mailing Fax
- (607) 873-1244
- Practice Street Address
- 200 Madison Ave Ste 2D
- Practice City
- Elmira
- Practice State
- NY
- Practice ZIP Code
- 14901-3219
- Practice Country
- US
- Practice Phone
- (607) 873-1832
- Practice Fax
- (607) 873-1833
- Enumeration Date
- June 23, 2017
- Last Updated
- November 30, 2020
- Sex
- Female
- Sole Proprietor
- No
- Certification Date
- November 30, 2020
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Nurse Practitioner (363L00000X)
- Other Identifiers
- 103436736 (PA), 04882968 (NY)