Mr. Kenneth Lee Russell, NAVYSOIDC
Mr. Kenneth Lee Russell, NAVYSOIDC is an Independent Duty Corpsman in Camp Lejeune, North Carolina. Practices as a sole proprietor. Registered with an NPI since 2018.
- In the registry since
- 2018
Practice location Address checks out
3D Marine Raider BattalionCamp Lejeune, NC 28546
Phone: (360) 808-1590
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Independent Duty Corpsman (primary) | Taxonomy 1710I1002X |
|---|
Record details
| NPI number | 1639661192 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Credentials | NAVYSOIDC |
| Sole proprietor | Yes |
| NPI enumerated | May 31, 2018 |
| Last updated in NPPES | May 31, 2018 |
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