| NPI | 1902301237 |
|---|---|
| Former Name | KERRI E RUSSOM |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MS 902541) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MS 902541) |
| Enumeration Date | 2018-03-28 |
| Last Update Date | 2018-03-28 |