| NPI | 1801331871 |
|---|---|
| Former Name | KAREN GWEN RUSSELL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OK 50642) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: OK 50642) |
| Enumeration Date | 2016-12-30 |
| Last Update Date | 2018-03-23 |