Provider Demographics
NPI:1851547426
Name:FARLEY, ZANDRA BRISTOL (RN)
Entity Type:Individual
Prefix:MRS
First Name:ZANDRA
Middle Name:BRISTOL
Last Name:FARLEY
Suffix:
Gender:F
Credentials:RN
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Mailing Address - Street 1:1532 LONE OAK ROAD SUITE 445
Mailing Address - Street 2:LOURDES MARSHALL NEMER PAVILLION
Mailing Address - City:PADUCAH
Mailing Address - State:KY
Mailing Address - Zip Code:42003
Mailing Address - Country:US
Mailing Address - Phone:270-538-5830
Mailing Address - Fax:270-538-5835
Practice Address - Street 1:1532 LONE OAK ROAD SUITE 445
Practice Address - Street 2:LOURDES MARSHALL NEMER PAVILLION
Practice Address - City:PADUCAH
Practice Address - State:KY
Practice Address - Zip Code:42003
Practice Address - Country:US
Practice Address - Phone:270-538-5830
Practice Address - Fax:270-538-5835
Is Sole Proprietor?:No
Enumeration Date:2008-08-14
Last Update Date:2008-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1103496163W00000X
KY102867246ZS0410X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No246ZS0410XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Technologist