Individual
MRS. KATHLEEN YOUNG HARRELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
17121 RAINBOW TERRACE, ODESSA, FL 33556
(813) 749-6707
(813) 475-4831
Mailing address
17121 RAINBOW TERRACE, ODESSA, FL 33556
(813) 749-6907
(813) 475-4831
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
2826532
FL
363LA2200X
Adult Health Nurse Practitioner
2826532
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
302647700
—
FL
Enumeration date
12/13/2005
Last updated
07/22/2014
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