Doctor Name: | MRS. LAURA NICHOLE LEE |
NPI Number: | 1053309526 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | FNP-C |
License Number: | RN154448 |
Business Practice Address: | 980 4th St Se Cairo, GA - 398283064 |
Business Phone Number: | 2293772002 |
Business Fax Number: | |
Mailing Address: | 1051 Boxwood Dr, BAINBRIDGE |
State: | GA |
Postal Code: | 398195102 |
Phone Number: | 2292463481 |
Fax Number: | |
NPI Enumeration Date: | 10/10/2005 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | RN154448 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | GA |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |