Keith, Mateland Lestery
Keith, Mateland Lestery is an individual health care provider with primary practice located at 421 Commercial Ct Ste B , Venice FL 34292-1656. He recently has 5 registered licenses in different health care specialties including Nursing Service Providers / Psychiatric/Mental Health, Adult, Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health, Nursing Service Providers / Addiction (Substance Use Disorder), Nursing Service Providers / Psychiatric/Mental Health, Child & Adolescent, Nursing Service Providers / Psychiatric/Mental Health. Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health is his primary health care specialty. Keith, Mateland Lestery can be contacted via phone (941) 244-4377.Contact Information
Primary practice address
421 Commercial Ct Ste B
Venice FL 34292-1656
Phone: (941) 244-4377
Fax: (941) 445-4186
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Nursing Service Providers / Psychiatric/Mental Health, Adult | 163WP0809X | 28243714A | Indiana |
| Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health | 363LP0808X | 11013737 | Florida |
| Nursing Service Providers / Addiction (Substance Use Disorder) | 163WA0400X | 28243714A | Indiana |
| Nursing Service Providers / Psychiatric/Mental Health, Child & Adolescent | 163WP0807X | 28243714A | Indiana |
| Nursing Service Providers / Psychiatric/Mental Health | 163WP0808X | 28243714A | Indiana |
Profile Details
| NPI number | 1457964843 |
|---|---|
| LBN Legal business name | Keith, Mateland Lestery |
| Credentials | PMHNP-ABC |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 26th, 2020 |
| Last updated | Sep 2nd, 2021 - about 3 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
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