Provider Demographics
NPI:1225452253
Name:PERSLEY, ZIBERIA (CNA)
Entity type:Individual
Prefix:
First Name:ZIBERIA
Middle Name:
Last Name:PERSLEY
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2225 W BROADWAY
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40211-1003
Mailing Address - Country:US
Mailing Address - Phone:502-589-8910
Mailing Address - Fax:502-772-2084
Practice Address - Street 1:2225 W BROADWAY
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40211-1003
Practice Address - Country:US
Practice Address - Phone:502-589-8910
Practice Address - Fax:502-772-2084
Is Sole Proprietor?:No
Enumeration Date:2014-02-11
Last Update Date:2014-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN50086865376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide