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Individual
KATHRYN RUSSELL
Active
Individual
KATHRYN RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
4704431063
MI
363LN0000X
Neonatal Nurse Practitioner
7294725-4405
UT
363LN0000X
Neonatal Nurse Practitioner
73899
ID
363LN0005X
Critical Care Neonatal Nurse Practitioner
7294725-4405
UT
Other
Enumeration date
08/02/2018
Last updated
10/06/2025
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