Healthcare Provider Details

I. General information

NPI: 1780847814
Provider Name (Legal Business Name): KELLEY S. LESTER-GARRETT RN,MSN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/09/2008
Last Update Date: 07/09/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1941 LIMESTONE RD SUITE 210
WILMINGTON DE
19808-5408
US

IV. Provider business mailing address

1941 LIMESTONE RD SUITE 210
WILMINGTON DE
19808-5408
US

V. Phone/Fax

Practice location:
  • Phone: 302-998-0300
  • Fax: 302-998-5111
Mailing address:
  • Phone: 302-998-0300
  • Fax: 302-998-5111

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberF0408190
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: