Provider Demographics
NPI:1336034487
Name:NESTOR, JENNIFER RENAE (RN, CDCES)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:RENAE
Last Name:NESTOR
Suffix:
Gender:F
Credentials:RN, CDCES
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:106 W MAIN ST STE 203
Mailing Address - Street 2:
Mailing Address - City:KINGWOOD
Mailing Address - State:WV
Mailing Address - Zip Code:26537-1131
Mailing Address - Country:US
Mailing Address - Phone:304-329-0096
Mailing Address - Fax:
Practice Address - Street 1:106 W MAIN ST STE 203
Practice Address - Street 2:
Practice Address - City:KINGWOOD
Practice Address - State:WV
Practice Address - Zip Code:26537-1131
Practice Address - Country:US
Practice Address - Phone:304-329-0096
Practice Address - Fax:304-329-3103
Is Sole Proprietor?:No
Enumeration Date:2025-06-10
Last Update Date:2025-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV52283163WD0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WD0400XNursing Service ProvidersRegistered NurseDiabetes Educator