Elizabeth Russ, | |
64 Maple St Ext, Unit A, Kent, CT 06757 | |
(860) 419-5925 | |
Not Available |
Full Name | Elizabeth Russ |
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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 | Mobile Care Partners Of Connecticut Pllc |
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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 | |
Zachary Farrell, Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 62 Carter Rd, Kent, CT 06757 Phone: 860-927-3772 |