Provider Demographics
NPI:1992756431
Name:LESTER, DANA H (NP)
Entity type:Individual
Prefix:
First Name:DANA
Middle Name:H
Last Name:LESTER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:DANA
Other - Middle Name:H
Other - Last Name:BRASEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:6 ENGLISH OAKS BLVD NE
Mailing Address - Street 2:
Mailing Address - City:ROME
Mailing Address - State:GA
Mailing Address - Zip Code:30165-9322
Mailing Address - Country:US
Mailing Address - Phone:706-409-3131
Mailing Address - Fax:
Practice Address - Street 1:1110 BURLEYSON DR
Practice Address - Street 2:
Practice Address - City:DALTON
Practice Address - State:GA
Practice Address - Zip Code:30720-2509
Practice Address - Country:US
Practice Address - Phone:706-226-1021
Practice Address - Fax:706-278-0619
Is Sole Proprietor?:No
Enumeration Date:2006-05-12
Last Update Date:2011-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN 039939363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA814589421BMedicaid
GA814589421CMedicaid
GA50BBLNCMedicare PIN
GA814589421BMedicaid