Provider Demographics
NPI:1477542629
Name:LESTER-SIMMONDS, STEPHANIE L (MD)
Entity Type:Individual
Prefix:DR
First Name:STEPHANIE
Middle Name:L
Last Name:LESTER-SIMMONDS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:STEPHANIE
Other - Middle Name:L
Other - Last Name:LESTER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:11415 SEYMOUR LN
Mailing Address - Street 2:
Mailing Address - City:SPOTSYLVANIA
Mailing Address - State:VA
Mailing Address - Zip Code:22551-4633
Mailing Address - Country:US
Mailing Address - Phone:540-287-0041
Mailing Address - Fax:540-972-3686
Practice Address - Street 1:11415 SEYMOUR LN
Practice Address - Street 2:
Practice Address - City:SPOTSYLVANIA
Practice Address - State:VA
Practice Address - Zip Code:22551-4633
Practice Address - Country:US
Practice Address - Phone:540-287-0041
Practice Address - Fax:540-972-3686
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-20
Last Update Date:2010-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101229425207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA6208967Medicaid
160001792Medicare ID - Type Unspecified
G94432Medicare UPIN