Provider Demographics
NPI:1780847814
Name:LESTER-GARRETT, KELLEY S (RN,MSN)
Entity Type:Individual
Prefix:MS
First Name:KELLEY
Middle Name:S
Last Name:LESTER-GARRETT
Suffix:
Gender:F
Credentials:RN,MSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1941 LIMESTONE RD
Mailing Address - Street 2:SUITE 210
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19808-5408
Mailing Address - Country:US
Mailing Address - Phone:302-998-0300
Mailing Address - Fax:302-998-5111
Practice Address - Street 1:1941 LIMESTONE RD
Practice Address - Street 2:SUITE 210
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19808-5408
Practice Address - Country:US
Practice Address - Phone:302-998-0300
Practice Address - Fax:302-998-5111
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-09
Last Update Date:2008-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEF0408190363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner