Russell, Kerrie

Russell, Kerrie is an individual health care provider with primary practice located at 14732 Old Spikes Rd , Panama City FL 32409-4637. She recently has only one registered license in Behavioral Health & Social Service Providers / Assistant Behavior Analyst, which is considered as her primary health care specialty. Russell, Kerrie can be contacted via phone (850) 867-2009.

Contact Information

Primary practice address
14732 Old Spikes Rd Panama City FL 32409-4637
Phone: (850) 867-2009
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Assistant Behavior Analyst 106E00000X 106E00000X Florida

Profile Details

NPI number 1932649886
LBN Legal business name Russell, Kerrie
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 26th, 2017
Last updated Feb 26th, 2017 - about 7 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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Identifiers

StateTypeNumberIssuer
All States NPI 1932649886 NPPES
Florida MEDICAID 017422400

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