Provider Demographics
NPI:1295953388
Name:LESHER, BEVERLY J (RN)
Entity type:Individual
Prefix:
First Name:BEVERLY
Middle Name:J
Last Name:LESHER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2959 BEAVER BROOK CT
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:MD
Mailing Address - Zip Code:21122-6333
Mailing Address - Country:US
Mailing Address - Phone:410-437-0076
Mailing Address - Fax:
Practice Address - Street 1:4804 MOUNTAIN RD
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:MD
Practice Address - Zip Code:21122-5816
Practice Address - Country:US
Practice Address - Phone:410-360-3367
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR096267163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool