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

Jessica Russell

Individual provider Licensed Practical Nurse · NPI 1396192258

Jessica Russell is a Licensed Practical Nurse in Waterford, Michigan. Licensed in Michigan. Registered with an NPI since 2016.

Licensed in
MI
In the registry since
2016

Practice location Address checks out

7712 Lake Ridge Dr
Waterford, MI 48327-4164
Phone: (248) 505-7204
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Licensed Practical Nurse (primary) Taxonomy 164W00000X · Licence 4703109555 (MI)

Record details

NPI number1396192258
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedMay 20, 2016
Last updated in NPPESMay 20, 2016
Mailing address7712 Lake Ridge Dr, Waterford, MI 48327-4164

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