Individual
KIMBERLY A. RUSSO
Active
Individual
KIMBERLY A. RUSSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
RN336781L
PA
367500000X
Certified Registered Nurse Anesthetist
L10036317
DE
367500000X
Certified Registered Nurse Anesthetist
Primary
L60A00549
DE
367500000X
Certified Registered Nurse Anesthetist
RN336781L
PA
367H00000X
Anesthesiologist Assistant
L10036317
DE
Other
Enumeration date
05/31/2006
Last updated
07/10/2015
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