Provider Demographics
NPI:1710620083
Name:VEST, LILLIAN MAY
Entity Type:Individual
Prefix:
First Name:LILLIAN
Middle Name:MAY
Last Name:VEST
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:PO BOX 193
Mailing Address - Street 2:
Mailing Address - City:FLAT TOP
Mailing Address - State:WV
Mailing Address - Zip Code:25841-0193
Mailing Address - Country:US
Mailing Address - Phone:681-368-1227
Mailing Address - Fax:
Practice Address - Street 1:3344 ELLISON RIDGE RD.
Practice Address - Street 2:
Practice Address - City:FLAT TOP
Practice Address - State:WV
Practice Address - Zip Code:25841
Practice Address - Country:US
Practice Address - Phone:681-368-1227
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-15
Last Update Date:2022-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant