Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LA2200X | Nurse Practitioner - Adult Health | 26NJ00643800 | NJ |
Y | 363LP2300X | Nurse Practitioner - Primary Care | 26NJ00643800 | NJ |
NPI | 1063864957 |
---|---|
Provider Name | Ms. Norma Lesta |
First Address | Paterson, NJ 07514-1916 |
Second Address | Paterson, NJ 07514-1916 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/07/2016 |
Last Update Date | 05/07/2016 |