| NPI | 1255878740 |
|---|---|
| Former Name | SAMANTHA HEATHER RUSSELL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: KS 5377031) |
| Enumeration Date | 2017-01-23 |
| Last Update Date | 2026-05-26 |