Provider Demographics
NPI:1689612152
Name:LESTER, KARLA LURELL (PA-C)
Entity Type:Individual
Prefix:MS
First Name:KARLA
Middle Name:LURELL
Last Name:LESTER
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:MISS
Other - First Name:KARLA
Other - Middle Name:LURELL
Other - Last Name:WHITCOMB
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:4 WOOLRIDGE WAY
Mailing Address - Street 2:
Mailing Address - City:GREER
Mailing Address - State:SC
Mailing Address - Zip Code:29650-2589
Mailing Address - Country:US
Mailing Address - Phone:828-551-2004
Mailing Address - Fax:864-295-2506
Practice Address - Street 1:10701 ANDERSON RD
Practice Address - Street 2:
Practice Address - City:EASLEY
Practice Address - State:SC
Practice Address - Zip Code:29642-9309
Practice Address - Country:US
Practice Address - Phone:864-295-2505
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-04
Last Update Date:2012-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0110001324363AM0700X
SC1301363AM0700X
NC0010-00487363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC2766647OtherMEDICARE
SC0707PAOtherMEDICAID SC
VA010105251Medicaid
VA004663F001Medicare ID - Type Unspecified
VA010105251Medicaid