Provider Demographics
NPI:1114245669
Name:JESTER, DANITA L (RN/LPN)
Entity Type:Individual
Prefix:
First Name:DANITA
Middle Name:L
Last Name:JESTER
Suffix:
Gender:F
Credentials:RN/LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1632 SPARKLE DR
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45237-1012
Mailing Address - Country:US
Mailing Address - Phone:513-226-5500
Mailing Address - Fax:
Practice Address - Street 1:1632 SPARKLE DR
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45237-1012
Practice Address - Country:US
Practice Address - Phone:513-226-5500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-07
Last Update Date:2023-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN.437828163W00000X
OHPN 129050 M-IV164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No164W00000XNursing Service ProvidersLicensed Practical Nurse