Doctor Name: | MIRANDA LESTER |
NPI Number: | 1316312994 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | RN |
License Number: | 61685 |
Business Practice Address: | 1 Stadium Dr Welch, WV - 248018100 |
Business Phone Number: | 3044365075 |
Business Fax Number: | |
Mailing Address: | 1 Stadium Dr, WELCH |
State: | WV |
Postal Code: | 248018100 |
Phone Number: | 3044365075 |
Fax Number: | |
NPI Enumeration Date: | 12/08/2015 |
NPI Last Update Date: | 12/08/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 163WS0200X |
License Number: | 61685 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | WV |
Taxonomy Type: | Nursing Service Providers |
Taxonomy Classification: | Registered Nurse |
Taxonomy Specialization: | School |
Taxonomy Definition: |