Individual
DR. NANCY KAE RUSSELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
5140 NE ANTIOCH RD, NURTURING OPTIMAL WELLNESS, KANSAS CITY, MO 64119-2523
(816) 453-5545
(800) 261-2718
Mailing address
5140 NE ANTIOCH RD, NURTURING OPTIMAL WELLNESS, KANSAS CITY, MO 64119-2523
(816) 453-5545
(800) 261-2718
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
36094
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12799020
NON-PROVIDER # BCBS
MO
01
—
68517
NON-PROVIDER # BCBS KS
KS
Enumeration date
10/13/2006
Last updated
12/07/2018
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