| Elizabeth Russ, | |
|
64 Maple St Ext, Unit A, Kent, CT 06757 | |
| (860) 419-5925 | |
| Not Available |
| Full Name | Elizabeth Russ |
|---|---|
| Gender | Female |
| Speciality | Nurse Practitioner - Family |
| Location | 64 Maple St Ext, Kent, Connecticut |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1811775117 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363LF0000X | Nurse Practitioner - Family | 12374 (Connecticut) | Primary |
| Entity Name | Community Health And Wellness Center Of Greater Torrington Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1356318091 PECOS PAC ID: 2365436847 Enrollment ID: O20041013001025 |
| Entity Name | Mobile Care Partners Of Connecticut Pllc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1760001010 PECOS PAC ID: 0547691834 Enrollment ID: O20200521001298 |
| Mailing Address | Practice Location Address |
|---|---|
| Elizabeth Russ, 64 Maple St Ext, Unit A, Kent, CT 06757 Ph: (860) 419-5925 | Elizabeth Russ, 64 Maple St Ext, Unit A, Kent, CT 06757 Ph: (860) 419-5925 |
Mrs. Michele Lynn Gervase, APRN Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 64 Maple St Ste A, Kent, CT 06757 Phone: 860-419-5925 | |
Lucille France, PMHNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 62 Carter Road, Kent, CT 06757 Phone: 860-927-3772 |