Provider Demographics
NPI:1134326382
Name:LESTER, TAMARA KAY (RN)
Entity Type:Individual
Prefix:
First Name:TAMARA
Middle Name:KAY
Last Name:LESTER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1415 CEDAR AVE
Mailing Address - Street 2:
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80304-3117
Mailing Address - Country:US
Mailing Address - Phone:303-938-9017
Mailing Address - Fax:
Practice Address - Street 1:2855 VALMONT RD
Practice Address - Street 2:
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80301-1309
Practice Address - Country:US
Practice Address - Phone:303-442-5160
Practice Address - Fax:303-440-8769
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-29
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO68299363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO29131782Medicaid