Provider Demographics
NPI:1578819363
Name:LESTER, CHRIS A (PA-C)
Entity Type:Individual
Prefix:
First Name:CHRIS
Middle Name:A
Last Name:LESTER
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 816
Mailing Address - Street 2:
Mailing Address - City:IAEGER
Mailing Address - State:WV
Mailing Address - Zip Code:24844-0816
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:RT. 103
Practice Address - Street 2:
Practice Address - City:WILCOE
Practice Address - State:WV
Practice Address - Zip Code:24895
Practice Address - Country:US
Practice Address - Phone:304-448-2174
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-30
Last Update Date:2012-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV00251363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant