Individual
CAROL LYNN RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
5520 COLLEGE BLVD, SUITE 200, OVERLAND PARK, KS 66211-1630
(913) 491-3040
Mailing address
3705 N 139TH ST, KANSAS CITY, KS 66109-4234
(913) 721-3641
(913) 721-3649
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
54607
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
910116805
—
MO
Enumeration date
01/28/2006
Last updated
10/21/2008
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