Mary Theresa Russell
NP | Nurse Practitioner - Adult Health | 19+ years Exp
3834 S Emerson Ave Ste 100, Indianapolis
Indiana, 46203
317-782-1577
Mary Theresa Russell is a Indianapolis, Indiana based nurse practitioner with 19 years of experience in Adult Health. She completed her graduation in 2006. She accepts the Medicare-approved amount. Patients will not be billed for any more than the Medicare deductible and coinsurance. Active license number of Mary Theresa Russell is 71002193A for Adult Health in Indiana. Her current practice location is 3834 S Emerson Ave Ste 100, Indianapolis. Patients can reach her at 317-782-1577 or can fax her at 317-780-5549. Mary Theresa Russell is NP with specialization in Adult Health and her NPI number (Unique professional ID assigned by NPPES) is 1770590374.
Mary Theresa Russell can evaluate, diagnose patients overall wellness, and conditions such as cancer, heart disease, diabetes, arthritis, sports injuries, and other ailments. She can see patients and promote healthy living and wellness. She can perform physical examinations, order and interpret tests, prescribe medications and treatments, and can also provide education and counseling to patients on wellness strategies and disease prevention.
Complete Profile:
Mary Theresa Russell speciality, credentials, practice address, contact phone number and fax are as below.
Patients can call on the below given phone number for appointment.
| Name: | Mary Theresa Russell |
| Specialization: | Adult Health Nurse Practitioner (ANP) |
| Gender: | Female |
| Credentials: | NP |
| Experience: | 19+ years |
| Medical School Attended: | Other |
| Graduation Year: | 2006 |
| Accepts Medicare Assignment: | Yes |
| Practice Address: | 3834 S Emerson Ave Ste 100, Indianapolis,
Indiana, 46203 |
| Phone: | 317-782-1577 |
| Fax: | 317-780-5549 |
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS).
NPI details are as mentioned below.
| PAC ID: | 5294734281 |
| Enrollment ID: | I20220506000962 |
| NPI Number: | 1770590374 |
| NPI Enumeration Date: | 03 Aug, 2006 |
| NPI Last Update On: | 25 Feb, 2020 |
Medical Licenses:
NPs can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Mary Theresa Russell are as mentioned below.
| License Number | Specialization | State | Status | |
| 71002193A | Adult Health | Indiana | Primary | |
Group Practice:
Group practices are practice of medicine by a group of NPs who share their premises and other resources. Following list states all the group name
with which Mary Theresa Russell is associated with along with the number of members in that group.
| Organization Name (Group PAC ID) | Members |
| Santibanez Holtzclaw Pc (4789807165) | 123 |
Other Medical Identifiers:
Other legacy medical identifiers associated with Mary Theresa Russell such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned as below.
| Identifier | Type | State | Issuer |
| 200492000 | Medicaid | Indiana | |
Business Mailing Address:
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
| Address: | Mary Theresa Russell
Po Box 3299,
Carson City, Nevada |
| Zip: | 89702-3299 |
| Phone Number: | 775-222-0044 |
| Fax Number: | 888-700-0187 |
Patients can reach Mary Theresa Russell at
3834 S Emerson Ave Ste 100, Indianapolis, Indiana or can
call to book an appointment on 317-782-1577.
Comments/ Reviews:
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Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 08 December, 2025.