Individual
KIMBERLY ANN RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
12541 FOSTER ST, SUITE 300, OVERLAND PARK, KS 66213-2630
(913) 317-3200
(913) 317-3218
Mailing address
901 E. 104TH ST., MAILSTOP 400N, KANSAS CITY, MO 64131-4517
(816) 502-7104
(816) 932-9670
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0428043
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100339820C
—
KS
Enumeration date
05/17/2006
Last updated
02/27/2018
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