| Doctor Name: | SHERRI CARLYLE RUSSELL |
| NPI Number: | 1063819993 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | NP |
| License Number: | 28098686A |
| Business Practice Address: | 115 S Murphy Ave Ste A Brazil, IN - 478348296 |
| Business Phone Number: | 8124422100 |
| Business Fax Number: | 8124464409 |
| Mailing Address: | 2723 S 7th St Ste A, TERRE HAUTE |
| State: | IN |
| Postal Code: | 478023558 |
| Phone Number: | 8122381730 |
| Fax Number: | 8122421565 |
| NPI Enumeration Date: | 11/20/2014 |
| NPI Last Update Date: | 10/30/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LA2200X |
| License Number: | 28098686A |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | IN |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Adult Health |
| Taxonomy Definition: | |