Provider Demographics
NPI:1871480319
Name:RUSSELL, ERICA KAY (DNP, APRN, FNP-C)
Entity type:Individual
Prefix:
First Name:ERICA
Middle Name:KAY
Last Name:RUSSELL
Suffix:
Gender:F
Credentials:DNP, APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 COWLES CLINIC WAY STE E-100
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:GA
Mailing Address - Zip Code:30642-4514
Mailing Address - Country:US
Mailing Address - Phone:762-445-1086
Mailing Address - Fax:
Practice Address - Street 1:1000 COWLES CLINIC WAY STE E-100
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:GA
Practice Address - Zip Code:30642-4514
Practice Address - Country:US
Practice Address - Phone:762-445-1086
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-18
Last Update Date:2025-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN306435363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily