Provider Demographics
NPI:1902042591
Name:HESTER, ZIMBERLIST WARDELL SR (LPN)
Entity Type:Individual
Prefix:MR
First Name:ZIMBERLIST
Middle Name:WARDELL
Last Name:HESTER
Suffix:SR
Gender:M
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:HHD 168TH MMB
Mailing Address - Street 2:UNIT 15021 BOX 20-B
Mailing Address - City:APO
Mailing Address - State:AP
Mailing Address - Zip Code:96218-5021
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:HHD 168TH MMB (AS)
Practice Address - Street 2:UNIT NUMBER 15021 BOX 20-B
Practice Address - City:APO
Practice Address - State:AP
Practice Address - Zip Code:96218-5021
Practice Address - Country:US
Practice Address - Phone:00182505-764-4190
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-02
Last Update Date:2009-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPN046331164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse