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Individual

SUSAN LEE PERRY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CRNA

Contact information

Practice address
4000 KRESGE WAY, LOUISVILLE, KY 40207-4605
(502) 473-2132
(502) 459-0923
Mailing address
PO BOX 70354, LOUISVILLE, KY 40270-0354
(502) 473-2132
(502) 459-0923

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
1043481
KY
367500000X
Certified Registered Nurse Anesthetist
Primary
3000182
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
74294208
KY
Enumeration date
08/17/2005
Last updated
12/02/2015
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