Healthcare Provider Details

I. General information

NPI: 1184408502
Provider Name (Legal Business Name): DESIREE NESTER FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/24/2023
Last Update Date: 07/26/2026
Certification Date: 07/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

117 S BROAD ST
LANSDALE PA
19446-3881
US

IV. Provider business mailing address

117 S BROAD ST APT 105
LANSDALE PA
19446-3881
US

V. Phone/Fax

Practice location:
  • Phone: 610-703-8276
  • Fax:
Mailing address:
  • Phone: 610-703-8276
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberSP028033
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: