Individual
KIRSTEN RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3331 W FLETCHER AVE, TAMPA, FL 33618-2810
(813) 972-4488
(888) 720-2931
Mailing address
PO BOX 748817, ATLANTA, GA 30374-8817
(813) 286-0033
(813) 282-1806
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
ME167926
FL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/08/2020
Last updated
08/28/2024
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