Healthcare Provider Details

I. General information

NPI: 1225452253
Provider Name (Legal Business Name): ZIBERIA PERSLEY CNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/11/2014
Last Update Date: 02/11/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2225 W BROADWAY
LOUISVILLE KY
40211-1003
US

IV. Provider business mailing address

2225 W BROADWAY
LOUISVILLE KY
40211-1003
US

V. Phone/Fax

Practice location:
  • Phone: 502-589-8910
  • Fax: 502-772-2084
Mailing address:
  • Phone: 502-589-8910
  • Fax: 502-772-2084

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code376K00000X
TaxonomyNurse's Aide
License Number50086865
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: