| Lacy D Russell, APRN | |
| 268 E Maple St, Salyersville, KY 41465-8032 | |
| (606) 349-5300 | |
| (606) 349-5312 | 
| Full Name | Lacy D Russell | 
|---|---|
| Gender | Female | 
| Speciality | Nurse Practitioner - Family | 
| Location | 268 E Maple St, Salyersville, Kentucky | 
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1275001869 | NPI | - | NPPES | 
| 7100600540 | Medicaid | KY | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 363LF0000X | Nurse Practitioner - Family | 3012873 (Kentucky) | Primary | 
| Entity Name | Aaron K. Jonan Memorial Clinic, Inc. | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1477569226 PECOS PAC ID: 5294632196 Enrollment ID: O20031218000126 | 
| Entity Name | Salyersville Medical Center, Llc | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1215984711 PECOS PAC ID: 4385539501 Enrollment ID: O20040217000889 | 
| Mailing Address | Practice Location Address | 
|---|---|
| Lacy D Russell, APRN 268 E Maple St, Salyersville, KY 41465-8032 Ph: (606) 349-5300 | Lacy D Russell, APRN 268 E Maple St, Salyersville, KY 41465-8032 Ph: (606) 349-5300 | 
| Heather Blair, APRN Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 940 Parkway Dr, Salyersville, KY 41465 Phone: 606-298-3412 | |
| Maria Tackett, APRN Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 214 Beriah Blvd, Salyersville, KY 41465 Phone: 606-349-5126 Fax: 606-349-5123 | |
| Samantha Nicole Mccarty, APRN Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 823 Wolfpen Br, Salyersville, KY 41465 Phone: 606-367-3334 | |
| Christy Ann Allen, APRN-CNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 3043 Down And Around Rd, Salyersville, KY 41465 Phone: 606-496-5243 Fax: 606-496-5243 | |
| Mrs. Patsy Jackson, APRN Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 787 Parkway Dr, Salyersville, KY 41465 Phone: 606-889-3221 | |
| Kristen Predmore, APRN, PMHNP-BC Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 842 E Mountain Pkwy, Salyersville, KY 41465 Phone: 606-349-8100 Fax: 606-349-8150 |