Kristen Russell
Individual provider Active NPI Athletic Trainer · New Concord, OH
NPI 1205325321 · NPPES record last updated May 3, 2018
Key facts
- NPI
- 1205325321
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Athletic Trainer 2255A2300X
- Practice address
- 163 Stormont St
New Concord, OH 43762-1118 - Phone
- (740) 826-8211
- NPI assigned
- May 3, 2018
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Muskingum University | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | Yes |
Addresses
Primary practice location
163 Stormont St
New Concord, OH 43762-1118
Mailing address
310 Main St
Tiltonsville, OH 43963-1065
Phone (304) 231-4901
Other providers in New Concord, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 3, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.