Healthcare Provider Details

I. General information

NPI: 1881639961
Provider Name (Legal Business Name): SHARON ZIBART RN
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 06/20/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

332 W BROADWAY
LOUISVILLE KY
40202-2130
US

IV. Provider business mailing address

332 W BROADWAY
LOUISVILLE KY
40202-2133
US

V. Phone/Fax

Practice location:
  • Phone: 502-583-0909
  • Fax: 502-583-0913
Mailing address:
  • Phone: 502-583-0909
  • Fax: 502-583-0913

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number1022399
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: