Provider Demographics
NPI:1659451151
Name:KESTER, JANE
Entity Type:Individual
Prefix:
First Name:JANE
Middle Name:
Last Name:KESTER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1101 GREENVILLE BLVD SE
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27858-4529
Mailing Address - Country:US
Mailing Address - Phone:252-756-6533
Mailing Address - Fax:252-756-5746
Practice Address - Street 1:1101 GREENVILLE BLVD SE
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27858-4529
Practice Address - Country:US
Practice Address - Phone:252-756-6533
Practice Address - Fax:252-756-5746
Is Sole Proprietor?:No
Enumeration Date:2006-10-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC383225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics