Provider Demographics
NPI:1790168789
Name:LESTER, BRANDI (CRNP)
Entity Type:Individual
Prefix:MRS
First Name:BRANDI
Middle Name:
Last Name:LESTER
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5004 HIGHWAY 69 N
Mailing Address - Street 2:
Mailing Address - City:NORTHPORT
Mailing Address - State:AL
Mailing Address - Zip Code:35473-2039
Mailing Address - Country:US
Mailing Address - Phone:205-339-2499
Mailing Address - Fax:205-339-6422
Practice Address - Street 1:5004 HIGHWAY 69 N
Practice Address - Street 2:
Practice Address - City:NORTHPORT
Practice Address - State:AL
Practice Address - Zip Code:35473-2039
Practice Address - Country:US
Practice Address - Phone:205-339-2499
Practice Address - Fax:205-339-6422
Is Sole Proprietor?:No
Enumeration Date:2015-07-08
Last Update Date:2015-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-100104207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine