Individual
MRS. KATHLEEN ANNE RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP-BC
Contact information
Practice address
6400 SAINT JOHNS AVE, PALATKA, FL 32177-6817
(904) 279-2200
Mailing address
6400 SAINT JOHNS AVE, PALATKA, FL 32177-6817
(904) 279-2200
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
ARNP 2172092
FL
Other
Enumeration date
04/12/2012
Last updated
04/12/2012
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