Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Beverly Russell, PA

Individual provider Physician Assistant · NPI 1568573947

Beverly Russell, PA is a Physician Assistant in Jackson, Michigan. Licensed in Michigan. Registered with an NPI since 2006.

Licensed in
MI
In the registry since
2006
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

1111 Teneyck St
Jackson, MI 49201-2461
Phone: (517) 205-8940
Fax: (517) 205-0108
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 5601004024 (MI)

Record details

NPI number1568573947
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA
Sole proprietorNo
NPI enumeratedAugust 31, 2006
Last updated in NPPESJanuary 4, 2021
Certification dateDecember 28, 2020

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