IndividualActive
Jessica Russ, CCP
NPI 1174929129 · Perfusionist · Phoenix, AZ
Provider details
- NPI number
- 1174929129
- Entity type
- Individual
- Primary specialty
- PerfusionistTechnologists, Technicians & Other Technical Service Providers
- Credential
- CCP
- Sex
- Female
- Sole proprietor
- No
- License
- LP030 (NV)
Practice location
10930 N Tatum Blvd
Ste 103
Phoenix, AZ 85028-6069
Phone: (602) 263-7600
Fax: (602) 212-0365
Mailing address
10930 N Tatum Blvd
Phoenix, AZ 85028-6069
Registry dates
- Enumerated
- 2014-11-18
- Last updated
- 2014-11-18
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.