Individual
KARAN DAWN RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
1532 LONE OAK RD STE 345, PADUCAH, KY 42003-7942
(270) 444-2250
Mailing address
300 SE 2ND ST, STE 100, LEES SUMMIT, MO 64063-2759
(419) 251-9830
(419) 251-1826
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
77671
KS
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
3011211
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100484040
—
KY
Enumeration date
02/24/2014
Last updated
01/30/2019
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