Healthcare Provider Details

I. General information

NPI: 1134326382
Provider Name (Legal Business Name): TAMARA KAY LESTER RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/29/2007
Last Update Date: 03/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2855 VALMONT RD
BOULDER CO
80301-1309
US

IV. Provider business mailing address

1415 CEDAR AVE
BOULDER CO
80304-3117
US

V. Phone/Fax

Practice location:
  • Phone: 303-442-5160
  • Fax: 303-440-8769
Mailing address:
  • Phone: 303-938-9017
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number68299
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: