Stephanie M. Russell MD Psc

NPI #1164508198 in Prospect, Kentucky

Provider Information

NPI Number: 1164508198
Entity Type: Organization
Organization Name: Stephanie M. Russell MD Psc
Primary Specialty: Pediatrics
Enumeration Date: Oct 31, 2006
Last Updated: Mar 11, 2010

Practice Location

Address: 10639 MEETING STREET
Address 2: SUITE 101
City: Prospect
State: Kentucky
ZIP Code: 40059-7544
Phone: (502) 425-7827

Authorized Official

Name: STEPHANIE M. RUSSELL, MD
Title: OWNER
Phone: (502) 425-7827

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Nurse Practitioner - Family — Family	363LF0000X
Pediatrics	208000000X	Primary

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