| NPI | 1164508198 |
|---|---|
| Doing Business As | KIDZLIFE PEDIATRICS |
| Entity Type | Organization |
| Authorized Contact | STEPHANIE M. RUSSELL Owner 502-425-7827 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208000000X Pediatrics |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family |
| Enumeration Date | 2006-10-31 |
| Last Update Date | 2010-03-11 |