Doctor Name: | MELISSA MORTON LEE |
NPI Number: | 1265812408 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | FNP |
License Number: | 178822 |
Business Practice Address: | 87 S Burnt Mill Rd La Fayette, GA - 307284263 |
Business Phone Number: | 7069962797 |
Business Fax Number: | 7066572958 |
Mailing Address: | 13570 N Main St, TRENTON |
State: | GA |
Postal Code: | 307522012 |
Phone Number: | 7069562665 |
Fax Number: | 7066572958 |
NPI Enumeration Date: | 06/03/2015 |
NPI Last Update Date: | 04/20/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | 178822 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | TN |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |