Russell, Kathryn

Russell, Kathryn is an individual health care provider with primary practice located at 190 E Bannock St , Boise ID 83712-6241. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Neonatal, Physician Assistants & Advanced Practice Nursing Providers / Neonatal, Critical Care. Physician Assistants & Advanced Practice Nursing Providers / Neonatal is her primary health care specialty. Russell, Kathryn can be contacted via phone (208) 381-2088.

Contact Information

Primary practice address
190 E Bannock St Boise ID 83712-6241
Phone: (208) 381-2088
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Neonatal 363LN0000X 7294725-4405 Utah
Physician Assistants & Advanced Practice Nursing Providers / Neonatal, Critical Care 363LN0005X 7294725-4405 Utah
Physician Assistants & Advanced Practice Nursing Providers / Neonatal 363LN0000X 73899 Idaho

Profile Details

NPI number 1568940377
LBN Legal business name Russell, Kathryn
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 2nd, 2018
Last updated Nov 3rd, 2022 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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