Individual provider · Type 1 NPI
Kelsey Russo
Student in an Organized Health Care Education/Training Program · Lake Ariel, PA
NPI number
1467993626
Active
Practice location
2362 Tanglewood Lane
Lake Ariel, PA 18436
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Athletic Trainer | 2255A2300X | 2255A2300 (PA) |
| Student in an Organized Health Care Education/Training Program Primary | 390200000X | None listed |
Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
About NPI 1467993626
Kelsey Russo's National Provider Identifier is 1467993626, issued on Mar 20, 2017. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Lake Ariel, PA. The record was last updated on Mar 20, 2017.