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Individual

PENIE LEANN LESTER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
R.N.

Contact information

Practice address
1233 S.W. AVENUE EXT., JOHNSON CITY, TN 37604
(423) 979-4653
Mailing address
132 JACK MARTIN LN, GRAY, TN 37615-4105

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN0000074659
TN

Other

Enumeration date
02/26/2007
Last updated
07/08/2007
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