Provider Demographics
NPI:1457966947
Name:NESTER, LAUREN PAIGE (RN, LMBT)
Entity Type:Individual
Prefix:MS
First Name:LAUREN
Middle Name:PAIGE
Last Name:NESTER
Suffix:
Gender:F
Credentials:RN, LMBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:113 PAGODA CT.
Mailing Address - Street 2:
Mailing Address - City:HAMPSTEAD
Mailing Address - State:NC
Mailing Address - Zip Code:28443
Mailing Address - Country:US
Mailing Address - Phone:919-500-2825
Mailing Address - Fax:
Practice Address - Street 1:113 PAGODA CT.
Practice Address - Street 2:
Practice Address - City:HAMPSTEAD
Practice Address - State:NC
Practice Address - Zip Code:28443
Practice Address - Country:US
Practice Address - Phone:919-500-2825
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-10
Last Update Date:2020-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC17781225700000X
NC244503163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163W00000XNursing Service ProvidersRegistered NurseGroup - Multi-Specialty
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC244503OtherREGISTERED NURSE PERMANENT LICENSE
NC17781OtherLICENSED MASSAGE & BODYWORK THERAPIST