Individual
KATHRYN RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
3333 SILAS CREEK PKWY, WINSTON-SALEM, NC 27103-3013
(336) 718-5000
Mailing address
2085 FRONTIS PLAZA BLVD, WINSTON-SALEM, NC 27103-5614
(336) 277-1065
(336) 277-1152
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
037333
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8052038
—
NC
Enumeration date
06/26/2006
Last updated
08/01/2012
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