Provider Demographics
NPI:1003385345
Name:KESTERSON, CAROLINE (FNP)
Entity Type:Individual
Prefix:MRS
First Name:CAROLINE
Middle Name:
Last Name:KESTERSON
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4708 ALLIANCE BLVD STE 550
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093-5363
Mailing Address - Country:US
Mailing Address - Phone:469-800-6140
Mailing Address - Fax:
Practice Address - Street 1:4708 ALLIANCE BLVD STE 550
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-5363
Practice Address - Country:US
Practice Address - Phone:469-800-6140
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-11-15
Last Update Date:2018-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP137864363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily