Provider Demographics
NPI:1942172598
Name:RUSSELL, SHAINA
Entity type:Individual
Prefix:
First Name:SHAINA
Middle Name:
Last Name:RUSSELL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:729 E ST
Mailing Address - Street 2:
Mailing Address - City:PAWNEE CITY
Mailing Address - State:NE
Mailing Address - Zip Code:68420-3076
Mailing Address - Country:US
Mailing Address - Phone:402-852-2411
Mailing Address - Fax:402-852-2993
Practice Address - Street 1:729 E ST
Practice Address - Street 2:
Practice Address - City:PAWNEE CITY
Practice Address - State:NE
Practice Address - Zip Code:68420-3076
Practice Address - Country:US
Practice Address - Phone:402-852-2411
Practice Address - Fax:402-852-2993
Is Sole Proprietor?:No
Enumeration Date:2025-09-23
Last Update Date:2025-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant