Provider Demographics
NPI:1346857299
Name:NESBITT, IESHIA (LPN)
Entity Type:Individual
Prefix:
First Name:IESHIA
Middle Name:
Last Name:NESBITT
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9633 NE 2ND DR
Mailing Address - Street 2:
Mailing Address - City:WILDWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:34785-8440
Mailing Address - Country:US
Mailing Address - Phone:352-547-9543
Mailing Address - Fax:
Practice Address - Street 1:9633 NE 2ND DR
Practice Address - Street 2:
Practice Address - City:WILDWOOD
Practice Address - State:FL
Practice Address - Zip Code:34785-8440
Practice Address - Country:US
Practice Address - Phone:352-547-9543
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-24
Last Update Date:2020-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPN5232848164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse