| Doctor Name: | RONALD KENT NESTLE |
| NPI Number: | 1164645149 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | LADAC |
| License Number: | 0064311 |
| Business Practice Address: | 800 East Ninth Street Sierra Vista Hospital Truth Or Consequences, NM - 87901 |
| Business Phone Number: | 5058942111 |
| Business Fax Number: | 5058947659 |
| Mailing Address: | 800 East Ninth Street, Sierra Vista Hospital TRUTH OR CONSEQUENCES |
| State: | NM |
| Postal Code: | 87901 |
| Phone Number: | 5058942111 |
| Fax Number: | 5058947659 |
| NPI Enumeration Date: | 04/10/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | 0064311 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NM |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |