| Doctor Name: | MRS. KATHLEEN YOUNG HARRELL |
| NPI Number: | 1043295090 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | ARNP |
| License Number: | 2826532 |
| Business Practice Address: | 17121 Rainbow Terrace Odessa, FL - 33556 |
| Business Phone Number: | 8137496707 |
| Business Fax Number: | 8134754831 |
| Mailing Address: | 17121 Rainbow Terrace, ODESSA |
| State: | FL |
| Postal Code: | 33556 |
| Phone Number: | 8137496907 |
| Fax Number: | 8134754831 |
| NPI Enumeration Date: | 12/13/2005 |
| NPI Last Update Date: | 07/22/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LA2200X |
| License Number: | 2826532 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | FL |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Adult Health |
| Taxonomy Definition: | |