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

Mr. Russell William Lilly, PMHNP

Individual provider Psychiatric/Mental Health Nurse Practitioner · NPI 1639824063

Mr. Russell William Lilly, PMHNP is a Nurse Practitioner in Freemansburg, Pennsylvania. Qualified in 2018, 8 years ago. Practices with Vital Healthcare Solutions, a 105-clinician group and accepts Medicare assignment. Licensed in Pennsylvania.

Years since qualifying
8
Licensed in
PA
In the registry since
2022
What do these letters mean?
PMHNP — Psychiatric-Mental Health Nurse Practitioner
A nurse practitioner specialising in mental health, able to prescribe psychiatric medication.

See every abbreviation used in this directory →

Practice location Address checks out

832 Kossuth St
Freemansburg, PA 18017-7117
Phone: (610) 704-1479
Show map & directions

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

Specialties & licences

Psychiatric/Mental Health Nurse Practitioner (primary) Taxonomy 363LP0808X · Licence SP02014 (PA)

Record details

NPI number1639824063
Entity typeIndividual (Type 1)
GenderMale
Credentials PMHNP
Sole proprietorNo
NPI enumeratedFebruary 15, 2022
Last updated in NPPESApril 30, 2024
Certification dateFebruary 15, 2022

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 Vital Healthcare Solutions — 105 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare