Provider Demographics
NPI:1811550668
Name:JESTER, DONNA E (LPN)
Entity Type:Individual
Prefix:
First Name:DONNA
Middle Name:E
Last Name:JESTER
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:870 ELLIOTT DR
Mailing Address - Street 2:
Mailing Address - City:LEWISTON
Mailing Address - State:NY
Mailing Address - Zip Code:14092-2000
Mailing Address - Country:US
Mailing Address - Phone:716-417-6867
Mailing Address - Fax:
Practice Address - Street 1:870 ELLIOTT DR
Practice Address - Street 2:
Practice Address - City:LEWISTON
Practice Address - State:NY
Practice Address - Zip Code:14092-2000
Practice Address - Country:US
Practice Address - Phone:716-417-6867
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-17
Last Update Date:2019-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY165758-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse