| Doctor Name: | KIMBERLEY A RUSSELL |
| NPI Number: | 1386781060 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | NP |
| License Number: | AP081884 |
| Business Practice Address: | 35 Walker St Kittery, ME - 039041727 |
| Business Phone Number: | 2074394430 |
| Business Fax Number: | 2074390968 |
| Mailing Address: | 35 Walker St, KITTERY |
| State: | ME |
| Postal Code: | 039041727 |
| Phone Number: | 2074394430 |
| Fax Number: | 2074390968 |
| NPI Enumeration Date: | 01/31/2007 |
| NPI Last Update Date: | 03/26/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | AP081884 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | ME |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |