Provider Demographics
NPI:1487832309
Name:ANNE K NESTOR MD LLC
Entity Type:Organization
Organization Name:ANNE K NESTOR MD LLC
Other - Org Name:CARLISLE FAMILY PRACTICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MD
Authorized Official - Prefix:DR
Authorized Official - First Name:ANNE
Authorized Official - Middle Name:K
Authorized Official - Last Name:NESTOR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:937-746-2813
Mailing Address - Street 1:300 BUSINESS PKWY
Mailing Address - Street 2:
Mailing Address - City:CARLISLE
Mailing Address - State:OH
Mailing Address - Zip Code:45005
Mailing Address - Country:US
Mailing Address - Phone:937-746-2813
Mailing Address - Fax:937-746-2753
Practice Address - Street 1:300 BUSINESS PKWY
Practice Address - Street 2:
Practice Address - City:CARLISLE
Practice Address - State:OH
Practice Address - Zip Code:45005
Practice Address - Country:US
Practice Address - Phone:937-746-2813
Practice Address - Fax:937-746-2753
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-01
Last Update Date:2008-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1144204892OtherNPI INDIVIDUAL
OH0880257Medicaid
OHF30249Medicare UPIN
OH0880257Medicaid