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

Jacqueline Blake Russ, APRN

Individual provider Nurse Practitioner · NPI 1891279584

Jacqueline Blake Russ, APRN is a Nurse Practitioner in Louisville, Kentucky. Qualified in 2018, 8 years ago. Practices with Sn Kentuckiana Rehab, LLC, a 343-clinician group, works from 3 locations, accepts Medicare assignment and offers telehealth. Licensed in Kentucky.

Years since qualifying
8
Licensed in
KY
In the registry since
2018
What do these letters mean?
APRN — Advanced Practice Registered Nurse
The umbrella licence covering nurse practitioners, midwives, anaesthetists and clinical nurse specialists.

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Practice location Address checks out

4123 Dutchmans Ln Ste 307
Louisville, KY 40207-4721
Phone: (502) 409-5600
Fax: (502) 259-3078
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (2)

  • 4001 Dutchmans Ln, Louisville, KY 40207-4714 — (502) 893-1000
  • 100 Mallard Creek Rd Ste 406, Louisville, KY 40207-5166 — (502) 895-4607

Specialties & licences

Nurse Practitioner (primary) Taxonomy 363L00000X · Licence 3012682 (KY)

Record details

NPI number1891279584
Entity typeIndividual (Type 1)
GenderFemale
Credentials APRN
Sole proprietorNo
NPI enumeratedSeptember 19, 2018
Last updated in NPPESNovember 18, 2024
Certification dateNovember 18, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2018 (8 years in practice)
Group practice Sn Kentuckiana Rehab, Llc — 343 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations3 on file with Medicare

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