| 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 |
| Experience | 3 Years |
| Location | 64 Maple St Ext, Kent, Connecticut |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1811775117 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363LF0000X | Nurse Practitioner - Family | 12374 (Connecticut) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Sharon Hospital | Sharon, CT | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Mobile Care Partners Of Connecticut Pllc | 0547691834 | 5 |
| Community Health And Wellness Center Of Greater Torrington Inc | 2365436847 | 26 |
| 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: May Accept Medicare Assignments 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 |