Provider Demographics
NPI:1689201444
Name:NESTER, LORRAINE KATHRYN (RD, LD, IBCLC)
Entity Type:Individual
Prefix:
First Name:LORRAINE
Middle Name:KATHRYN
Last Name:NESTER
Suffix:
Gender:F
Credentials:RD, LD, IBCLC
Other - Prefix:
Other - First Name:LORI
Other - Middle Name:
Other - Last Name:NESTER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RD, LD, IBCLC
Mailing Address - Street 1:103 N LAWN AVE
Mailing Address - Street 2:
Mailing Address - City:BLUFFTON
Mailing Address - State:OH
Mailing Address - Zip Code:45817-1221
Mailing Address - Country:US
Mailing Address - Phone:419-358-9650
Mailing Address - Fax:
Practice Address - Street 1:103 N LAWN AVE
Practice Address - Street 2:
Practice Address - City:BLUFFTON
Practice Address - State:OH
Practice Address - Zip Code:45817-1221
Practice Address - Country:US
Practice Address - Phone:419-358-9650
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-23
Last Update Date:2020-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
174N00000X
OHLD.4008133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
No174N00000XOther Service ProvidersLactation Consultant, Non-RN