# KATHRYN RUSSELL

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1568940377
- **Gender:** F
- **Credential:** NP

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363L00000X | Nurse Practitioner | 4704431063 | MI | Yes |
| 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