Individual provider · Type 1 NPI
Kimberly Anne Russell, PA-C
Medical Physician Assistant · Oklahoma City, OK
NPI number
1932209558
Active
Practice location
Vamc 921 NE 13th Street, 2A-137
Oklahoma City, OK 73104
Fax (405) 456-1504
Mailing address
921 NE 13th St # 2A-133
Oklahoma City, OK 73104-5007
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Physician Assistant | 363A00000X | PA744 (OK) |
| Medical Physician Assistant Primary | 363AM0700X | 744 (OK) |
Medical Physician Assistant: Definition to come...
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About NPI 1932209558
Kimberly Anne Russell, PA-C's National Provider Identifier is 1932209558, issued on Sep 24, 2006. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in Oklahoma City, OK. The record was last updated on Oct 6, 2021.