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General NPI Number Information
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NPI Number | 1851547426
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Entity Type | Individual
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Provider Name | ZANDRA BRISTOL FARLEY RN
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Gender | Female
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Dates
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Enumeration Date | 08/14/2008
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Last Update Date | 08/14/2008
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Provider Practice Location Address
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Address Line | 1532 LONE OAK ROAD SUITE 445 LOURDES MARSHALL NEMER PAVILLION
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City | PADUCAH
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State | KY
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Zip | 42003
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Country | US
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Telephone | 270-538-5830
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Fax | 270-538-5835
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Provider Business Mailing Address
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Address Line | 1532 LONE OAK ROAD SUITE 445 LOURDES MARSHALL NEMER PAVILLION
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City | PADUCAH
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State | KY
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Zip | 42003
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Country | US
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Telephone | 270-538-5830
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Fax | 270-538-5835
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 1103496
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License Number State | KY
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Taxonomy #2
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Taxonomy Code | 246ZS0410X
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Taxonomy Name | Surgical Technologist
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License Number | 102867
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License Number State | KY
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