| Doctor Name: | TERI ALLEGRA RUSSELL |
| NPI Number: | 1679565360 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | NP |
| License Number: | 0024080289 |
| Business Practice Address: | 45 Pine St Langley Afb, VA - 236652025 |
| Business Phone Number: | 7577646994 |
| Business Fax Number: | |
| Mailing Address: | 807 Captain John Smith Rd, NEWPORT NEWS |
| State: | VA |
| Postal Code: | 236063640 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 08/18/2005 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 163WW0101X |
| License Number: | 0024080289 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | VA |
| Taxonomy Type: | Nursing Service Providers |
| Taxonomy Classification: | Registered Nurse |
| Taxonomy Specialization: | Women's Health Care, Ambulatory |
| Taxonomy Definition: | |