Provider Demographics
NPI:1285095794
Name:LESTER, ALEA KRISTINE (RD, LD)
Entity type:Individual
Prefix:
First Name:ALEA
Middle Name:KRISTINE
Last Name:LESTER
Suffix:
Gender:F
Credentials:RD, LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3108 ENSIGN AVE N
Mailing Address - Street 2:
Mailing Address - City:NEW HOPE
Mailing Address - State:MN
Mailing Address - Zip Code:55427-2427
Mailing Address - Country:US
Mailing Address - Phone:612-710-7443
Mailing Address - Fax:
Practice Address - Street 1:3108 ENSIGN AVE N
Practice Address - Street 2:
Practice Address - City:NEW HOPE
Practice Address - State:MN
Practice Address - Zip Code:55427-2427
Practice Address - Country:US
Practice Address - Phone:612-710-7443
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-03-10
Last Update Date:2016-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN3675133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered