Provider Demographics
NPI:1699858266
Name:LESSER, NATHANIEL TODD (PNP)
Entity Type:Individual
Prefix:
First Name:NATHANIEL
Middle Name:TODD
Last Name:LESSER
Suffix:
Gender:M
Credentials:PNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:518 US ROUTE 1
Mailing Address - Street 2:
Mailing Address - City:KITTERY
Mailing Address - State:ME
Mailing Address - Zip Code:03904-2500
Mailing Address - Country:US
Mailing Address - Phone:207-351-3510
Mailing Address - Fax:207-438-9808
Practice Address - Street 1:518 US ROUTE 1
Practice Address - Street 2:
Practice Address - City:KITTERY
Practice Address - State:ME
Practice Address - Zip Code:03904-2500
Practice Address - Country:US
Practice Address - Phone:207-351-3510
Practice Address - Fax:207-438-9808
Is Sole Proprietor?:No
Enumeration Date:2006-10-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MERN50365363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics