Provider Demographics
NPI:1629554571
Name:NESTOR, DANE LEE (FNP)
Entity Type:Individual
Prefix:
First Name:DANE
Middle Name:LEE
Last Name:NESTOR
Suffix:
Gender:M
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:146 N HILL ST
Mailing Address - Street 2:
Mailing Address - City:ARVIN
Mailing Address - State:CA
Mailing Address - Zip Code:93203-1014
Mailing Address - Country:US
Mailing Address - Phone:661-304-4149
Mailing Address - Fax:
Practice Address - Street 1:146 N HILL ST
Practice Address - Street 2:
Practice Address - City:ARVIN
Practice Address - State:CA
Practice Address - Zip Code:93203-1014
Practice Address - Country:US
Practice Address - Phone:661-855-4468
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-13
Last Update Date:2022-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA843915163W00000X
CA95009915363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse