Provider Demographics
NPI:1033925367
Name:NESTER, SANDY (LPN)
Entity type:Individual
Prefix:MRS
First Name:SANDY
Middle Name:
Last Name:NESTER
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:MS
Other - First Name:SANDY
Other - Middle Name:
Other - Last Name:MASON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPN
Mailing Address - Street 1:140 LARKSPUR LN STE D
Mailing Address - Street 2:
Mailing Address - City:GALAX
Mailing Address - State:VA
Mailing Address - Zip Code:24333-2753
Mailing Address - Country:US
Mailing Address - Phone:276-236-6341
Mailing Address - Fax:
Practice Address - Street 1:140 LARKSPUR LN STE D
Practice Address - Street 2:
Practice Address - City:GALAX
Practice Address - State:VA
Practice Address - Zip Code:24333-2753
Practice Address - Country:US
Practice Address - Phone:276-236-6341
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-11
Last Update Date:2024-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0002085165164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse