National Provider Identifier

Annissa Russell

Annissa Russell is listed in the NPPES registry with a primary specialty of Registered Nurse in Kenmore, NY and a listed phone number of (716) 297-0798.

NPI 1891118964Kenmore, NYRegistered Nurse

Profile Overview

NPI
1891118964
Provider Type
Individual
Primary Specialty
Registered Nurse
Enumeration Date
January 27, 2014
Last Updated
January 27, 2014

Practice Location

  • 1370 Sheridan Dr
  • Kenmore, NY 14217-1253

Phone: (716) 297-0798

Specialties

  • Registered Nurse (163W00000X)
Full Record
NPI
1891118964
Entity Type
Individual
Last Name
Russell
First Name
Annissa
Provider Other Last Name
Russell
Provider Other First Name
Annissa
Provider Other Middle Name
Elaine
Provider Other Credential Text
RN
Provider Other Last Name Type Code
5
Mailing Street Address
1370 Sheridan Dr
Mailing City
Kenmore
Mailing State
NY
Mailing ZIP Code
14217-1253
Mailing Country
US
Mailing Phone
(716) 297-0798
Mailing Fax
(716) 297-0998
Practice Street Address
1370 Sheridan Dr
Practice City
Kenmore
Practice State
NY
Practice ZIP Code
14217-1253
Practice Country
US
Practice Phone
(716) 297-0798
Practice Fax
(716) 297-0998
Enumeration Date
January 27, 2014
Last Updated
January 27, 2014
Sex
Female
Sole Proprietor
No
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Registered Nurse (163W00000X)
Other Identifiers
650966 (NY, Nys License)