Provider Demographics
NPI:1124895396
Name:MESTER, LAURA J
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:J
Last Name:MESTER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4500 W LEHMAN RD
Mailing Address - Street 2:
Mailing Address - City:DEWITT
Mailing Address - State:MI
Mailing Address - Zip Code:48820-8014
Mailing Address - Country:US
Mailing Address - Phone:517-281-1185
Mailing Address - Fax:
Practice Address - Street 1:4500 W LEHMAN RD
Practice Address - Street 2:
Practice Address - City:DEWITT
Practice Address - State:MI
Practice Address - Zip Code:48820-8014
Practice Address - Country:US
Practice Address - Phone:517-281-1185
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-07
Last Update Date:2023-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider