Individual
KRISTEN RUSSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
4000 KRESGE WAY, LOUISVILLE, KY 40207-4605
(502) 897-8100
Mailing address
1115 MALLARD CREEK RD, LOUISVILLE, KY 40207-5841
(561) 901-1676
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
—
—
Other
Enumeration date
12/08/2023
Last updated
12/08/2023
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