Individual
RILEY L RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
21 N 12TH ST, KANSAS CITY, KS 66102-5161
(913) 342-2552
Mailing address
2706 W 79TH ST, PRAIRIE VILLAGE, KS 66208-3915
(785) 562-8697
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
TMP-162402
KS
Other
Enumeration date
05/21/2024
Last updated
05/21/2024
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