Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0808X | Nurse Practitioner - Psychiatric/Mental Health | R209720 | MD |
NPI | 1003452624 |
---|---|
Provider Name | Mrs. Ashley Ann Lester |
First Address | Baltimore, MD 21204-6819 |
Second Address | Baltimore, MD 21204-6819 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/11/2019 |
Last Update Date | 08/06/2020 |