Provider Demographics
NPI:1811153174
Name:GRIEL, LESTER C III (CRNP)
Entity type:Individual
Prefix:
First Name:LESTER
Middle Name:C
Last Name:GRIEL
Suffix:III
Gender:M
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:2520 GREEN TECH DR
Mailing Address - Street 2:STE C
Mailing Address - City:STATE COLLEGE
Mailing Address - State:PA
Mailing Address - Zip Code:16803-2300
Mailing Address - Country:US
Mailing Address - Phone:814-278-4898
Mailing Address - Fax:814-231-2004
Practice Address - Street 1:2520 GREEN TECH DR
Practice Address - Street 2:STE C
Practice Address - City:STATE COLLEGE
Practice Address - State:PA
Practice Address - Zip Code:16803-2300
Practice Address - Country:US
Practice Address - Phone:814-278-4898
Practice Address - Fax:814-231-2004
Is Sole Proprietor?:No
Enumeration Date:2008-08-05
Last Update Date:2013-08-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PASP009897363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily