Lori Russell, P.A.
Physician Assistant, Medical in Tullahoma, TN. Individual provider (NPI-1).
NPI number1891798377
StatusActive
Last updated in NPPESJul 6, 2012
Details
- NPI
- 1891798377
- Entity type
- Individual (NPI-1)
- Name
- Lori Russell
- Credential
- P.A.
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- May 27, 2005
- Last updated
- Jul 6, 2012
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · PRACTITIONER - PHYSICIAN ASSISTANT
- Can order and refer
- Part B Yes · DME Yes · Home health Yes · Power mobility Yes · Hospice No
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363AM0700X | Physician Assistant, Medical | 1198 | TN | Yes |
Other names
- Lori Neal (Former Name)
Practice location
100 Hunters LnSuite 100
Tullahoma, TN 37388-8263
Phone 931-455-4616 · Fax 931-455-2362
Mailing address
100 Hunters LnSuite 100
Tullahoma, TN 37388-8263
Phone 931-455-4616 · Fax 931-455-2362
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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All 7 Medical Physician Assistant providers in Tullahoma · All 812 providers in Tullahoma
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