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Individual
MARTHA KATHLEEN RUSSELL
Active
Individual
MARTHA KATHLEEN RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AGPCNP-BC
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
20237
SC
363LA2200X
Adult Health Nurse Practitioner
20237
SC
363LG0600X
Gerontology Nurse Practitioner
20237
SC
363LP2300X
Primary Care Nurse Practitioner
20237
SC
Other
Enumeration date
07/21/2016
Last updated
06/02/2025
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