| NPI | 1902301237 |
|---|---|
| Former Name | KERRI E RUSSOM |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TN 28583) |
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: TN 28583) |
| 363L00000X Nurse Practitioner (Licence: TN 28583) | |
| Enumeration Date | 2018-03-28 |
| Last Update Date | 2025-09-23 |