| Doctor Name: | JULIE L. RUSSELL |
| NPI Number: | 1225024839 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | NP |
| License Number: | 108385 |
| Business Practice Address: | 304 A East 4th St Eldon, MO - 65026 |
| Business Phone Number: | 5733925654 |
| Business Fax Number: | 5733925692 |
| Mailing Address: | 54 Hospital Dr, OSAGE BEACH |
| State: | MO |
| Postal Code: | 650653050 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 09/20/2005 |
| NPI Last Update Date: | 05/05/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | 108385 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MO |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |