Provider Demographics
NPI:1013615590
Name:ESTES, LETHA
Entity Type:Individual
Prefix:
First Name:LETHA
Middle Name:
Last Name:ESTES
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 1:1784 STATE ROUTE 229
Mailing Address - Street 2:
Mailing Address - City:ASHLEY
Mailing Address - State:OH
Mailing Address - Zip Code:43003-9795
Mailing Address - Country:US
Mailing Address - Phone:740-513-5563
Mailing Address - Fax:
Practice Address - Street 1:1784 STATE ROUTE 229
Practice Address - Street 2:
Practice Address - City:ASHLEY
Practice Address - State:OH
Practice Address - Zip Code:43003-9795
Practice Address - Country:US
Practice Address - Phone:740-513-5563
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-23
Last Update Date:2023-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker