Provider Demographics
NPI:1912615154
Name:LESNER, PAMELA JUNE
Entity Type:Individual
Prefix:
First Name:PAMELA
Middle Name:JUNE
Last Name:LESNER
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 1:2310 COUNTY ROAD 6
Mailing Address - Street 2:
Mailing Address - City:BARNUM
Mailing Address - State:MN
Mailing Address - Zip Code:55707-8748
Mailing Address - Country:US
Mailing Address - Phone:218-391-0222
Mailing Address - Fax:
Practice Address - Street 1:2310 COUNTY ROAD 6
Practice Address - Street 2:
Practice Address - City:BARNUM
Practice Address - State:MN
Practice Address - Zip Code:55707-8748
Practice Address - Country:US
Practice Address - Phone:218-391-0222
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-07
Last Update Date:2022-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN2479522163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health