Doctor Name: | LYNDELL SUE LEE |
NPI Number: | 1013951854 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | FNP |
License Number: | R851993 |
Business Practice Address: | 6051 Highway 49 Hattiesburg, MS - 394017200 |
Business Phone Number: | 6012887000 |
Business Fax Number: | |
Mailing Address: | Po Box 635614, CINCINNATI |
State: | OH |
Postal Code: | 452635614 |
Phone Number: | 8004430372 |
Fax Number: | 8655607310 |
NPI Enumeration Date: | 06/15/2006 |
NPI Last Update Date: | 06/04/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | R851993 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MS |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |