Russell, Kristin E
Russell, Kristin E is an sole proprietor health care provider with primary practice located at 1880 Quiet Cv , Fayetteville NC 28304-3857. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Medical, which is considered as her primary health care specialty. Russell, Kristin E can be contacted via phone (910) 323-2477.Contact Information
Primary practice address
1880 Quiet Cv
Fayetteville NC 28304-3857
Phone: (910) 323-2477
Fax: (910) 323-5931
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Medical | 363AM0700X | 104196 | North Carolina |
Profile Details
| NPI number | 1972544559 |
|---|---|
| LBN Legal business name | Russell, Kristin E |
| Credentials | Physician's Assistant Certified (PA-C) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jun 8th, 2006 |
| Last updated | Aug 19th, 2020 - about 4 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1972544559 | NPPES |
| North Carolina | Other | 124919 | PA CERTIFICATE OF REGISTR |
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