Healthcare Provider Details

I. General information

NPI: 1427086958
Provider Name (Legal Business Name): GLORIA ANN LESTER C.R.N.P., EDD.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/30/2006
Last Update Date: 04/24/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

105 N FRONT ST SUITE B NANTICOKE GYN ASSOC, PA
SEAFORD DE
19973-2707
US

IV. Provider business mailing address

31685 MILL CREEK CT
LEWES DE
19958-3632
US

V. Phone/Fax

Practice location:
  • Phone: 302-629-2434
  • Fax: 302-629-2459
Mailing address:
  • Phone: 302-645-5888
  • Fax: 302-629-2459

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License NumberLH0000104
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: