Basic Information
Provider Information
NPI: 1306278882
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: LESTER
FirstName: JESSICA
MiddleName: LEA
NamePrefix:  
NameSuffix:  
Credential: APRN
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: HURST
OtherFirstName: JESSICA
OtherMiddleName: LEA
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential: APRN
OtherLastNameType: 1
Mailing Information
Address1: PO BOX 990
Address2:  
City: DANVILLE
State: KY
PostalCode: 404230990
CountryCode: US
TelephoneNumber: 8592392360
FaxNumber: 8592396785
Practice Location
Address1: 466 LINDEN AVE STE B
Address2:  
City: HARRODSBURG
State: KY
PostalCode: 403301841
CountryCode: US
TelephoneNumber: 8597345173
FaxNumber:  
Other Information
ProviderEnumerationDate: 08/06/2013
LastUpdateDate: 05/15/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LF0000X3008149KYY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily

No ID Information.


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