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Individual

KRISTIN ERRYN RUSSELL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
1880 QUIET CV, FAYETTEVILLE, NC 28304-3857
(910) 323-2477
(910) 323-5931
Mailing address
1880 QUIET CV, FAYETTEVILLE, NC 28304-3857
(910) 323-2477
(910) 323-5931

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
104196
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
124919
PA CERTIFICATE OF REGISTR
NC
Enumeration date
06/08/2006
Last updated
05/04/2026
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