Kila Russell
Individual provider Active NPI Prosthetist · MC Donald, TN
NPI 1821743493 · NPPES record last updated Feb 13, 2022
Key facts
- NPI
- 1821743493
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Prosthetist 224P00000X
- Practice address
- 3818 S Lee Hwy
MC Donald, TN 37353-5876 - Phone
- (423) 320-7794
- NPI assigned
- Feb 13, 2022
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Prosthetist | 224P00000X | |||
| Prosthetist |
224P00000X | TN | Yes |
Addresses
Primary practice location
3818 S Lee Hwy
MC Donald, TN 37353-5876
Mailing address
3818 S Lee Hwy
MC Donald, TN 37353-5876
Phone (423) 320-7794
Other providers in MC Donald, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 13, 2022. 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.