Provider Demographics
NPI:1366281321
Name:PERRY, ALESHIA M
Entity type:Individual
Prefix:
First Name:ALESHIA
Middle Name:M
Last Name:PERRY
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 1:6844 BARDSTOWN RD UNIT 2243
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40291-3050
Mailing Address - Country:US
Mailing Address - Phone:502-438-5090
Mailing Address - Fax:
Practice Address - Street 1:6403 HUNTERS CREEK BLVD
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40258-3255
Practice Address - Country:US
Practice Address - Phone:502-438-5090
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-21
Last Update Date:2024-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY2052461164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse