Provider Demographics
NPI:1699141028
Name:LESTER, DESIREE (FNP-C)
Entity type:Individual
Prefix:
First Name:DESIREE
Middle Name:
Last Name:LESTER
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:701 PALUXY RD
Mailing Address - Street 2:
Mailing Address - City:GRANBURY
Mailing Address - State:TX
Mailing Address - Zip Code:76048-2355
Mailing Address - Country:US
Mailing Address - Phone:817-573-4585
Mailing Address - Fax:817-279-1153
Practice Address - Street 1:701 PALUXY RD
Practice Address - Street 2:
Practice Address - City:GRANBURY
Practice Address - State:TX
Practice Address - Zip Code:76048-2355
Practice Address - Country:US
Practice Address - Phone:817-573-4585
Practice Address - Fax:817-279-1153
Is Sole Proprietor?:No
Enumeration Date:2015-08-20
Last Update Date:2020-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP128104363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily