Provider Demographics
NPI:1538387873
Name:NESTER, CARLA MARIE (MD)
Entity type:Individual
Prefix:DR
First Name:CARLA
Middle Name:MARIE
Last Name:NESTER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MRS
Other - First Name:CARLA
Other - Middle Name:MARIE
Other - Last Name:LICHTENBERGER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:200 HAWKINS DR
Mailing Address - Street 2:4036BT
Mailing Address - City:IOWA CITY
Mailing Address - State:IA
Mailing Address - Zip Code:52242-1083
Mailing Address - Country:US
Mailing Address - Phone:319-353-7335
Mailing Address - Fax:319-384-9616
Practice Address - Street 1:200 HAWKINS DR
Practice Address - Street 2:4036BT
Practice Address - City:IOWA CITY
Practice Address - State:IA
Practice Address - Zip Code:52242-1009
Practice Address - Country:US
Practice Address - Phone:319-353-7335
Practice Address - Fax:319-384-9616
Is Sole Proprietor?:No
Enumeration Date:2007-04-23
Last Update Date:2012-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA37214207R00000X, 207RN0300X, 208000000X, 2080P0210X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0210XAllopathic & Osteopathic PhysiciansPediatricsPediatric Nephrology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA70084OtherWELLMARK BCBS
IAP00602252Medicare PIN
IAI20518Medicare PIN