Dr. Patrick Kelly Russell, DNAP, CRNA
Nurse Anesthetist, Certified Registered in Montclair, NJ. Individual provider (NPI-1).
NPI number1699485227
StatusActive
Last updated in NPPESDec 5, 2022
Details
- NPI
- 1699485227
- Entity type
- Individual (NPI-1)
- Name
- Dr. Patrick Kelly Russell
- Credential
- DNAP, CRNA
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Dec 5, 2022
- Certification date
- Dec 5, 2022
- Last updated
- Dec 5, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 367500000X | Nurse Anesthetist, Certified Registered | 26NJ01401400 | NJ | Yes |
| 367500000X | Nurse Anesthetist, Certified Registered | 95001877 | CA |
Practice location
1 Bay AveMontclair, NJ 07042-4837
Phone 973-429-6000
Mailing address
157 Clarken DrWest Orange, NJ 07052-3429
Phone 619-675-4910
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