KELLY RUSSELL

BOISE, ID
NPI1669938320
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363L00000X Nurse Practitioner
(Licence: ID  79075)
Additional Taxonomies363LF0000X Nurse Practitioner, Family
(Licence: CA  95008457)
Enumeration Date2019-02-18
Last Update Date2026-06-29
Business Address
KELLY RUSSELL MSN,RN,FNP-BC
900 N LIBERTY ST STE 101
BOISE, ID 83704-8858
Phone number: 208-367-8787
Mailing Address
KELLY RUSSELL MSN,RN,FNP-BC
PO BOX 190930
BOISE, ID 83719-0930
Phone number: 208-302-9342