Provider Demographics
NPI:1174419964
Name:RUSSELL, ZULEIMA DESIREE
Entity type:Individual
Prefix:
First Name:ZULEIMA
Middle Name:DESIREE
Last Name:RUSSELL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9500 WILLIAMSBURG PLZ APT 301
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40222-5066
Mailing Address - Country:US
Mailing Address - Phone:251-802-2071
Mailing Address - Fax:
Practice Address - Street 1:9700 STONESTREET RD
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40272-2884
Practice Address - Country:US
Practice Address - Phone:502-995-2400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-17
Last Update Date:2025-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program