Individual
LISA DIANE JESKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3141 CENTENNIAL BLVD, COLORADO SPRINGS, CO 80907-4094
(719) 327-5660
Mailing address
375 14TH ST, PENROSE, CO 81240-9053
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
48385
CO
Other
Enumeration date
09/01/2020
Last updated
09/01/2020
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