Individual
KATOSHA NICOLE RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSN, APRN, FNP-BC.
Contact information
Practice address
73 KINGSWOOD DR, CAMPBELLSVILLE, KY 42718-9604
(270) 789-1112
(270) 789-3157
Mailing address
PO BOX 909, LOUISVILLE, KY 40201-0909
(270) 789-1112
(270) 789-3157
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
3008196
KY
Other
Enumeration date
08/10/2013
Last updated
09/05/2013
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