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1508506536
KIMBERLY RUSSOM
UNION CITY, TN
NPI
1508506536
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: TN 31286)
Enumeration Date
2022-03-29
Last Update Date
2022-03-29
Business Address
KIMBERLY RUSSOM NP
1705 W REELFOOT AVE
UNION CITY, TN 38261-5569
Phone number: 731-599-1102
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Mailing Address
KIMBERLY RUSSOM NP
1705 W REELFOOT AVE
UNION CITY, TN 38261-5569
Phone number: 731-599-1102
Copy
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