Provider Demographics
NPI:1871724823
Name:HESTER, CARLENA E (LPN)
Entity type:Individual
Prefix:
First Name:CARLENA
Middle Name:E
Last Name:HESTER
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2422 HUDSON BAY WAY
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43232-4395
Mailing Address - Country:US
Mailing Address - Phone:614-589-9718
Mailing Address - Fax:
Practice Address - Street 1:2422 HUDSON BAY WAY
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43232-4395
Practice Address - Country:US
Practice Address - Phone:614-589-9718
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-06
Last Update Date:2009-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN128988-IV164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse