Doctor Name: | TINA L LEE |
NPI Number: | 1316217102 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LPN,CSA |
License Number: | |
Business Practice Address: | 15263 Sweetbriar Dr Basehor, KS - 660073031 |
Business Phone Number: | 8164195237 |
Business Fax Number: | |
Mailing Address: | 15263 Sweetbriar Dr, BASEHOR |
State: | KS |
Postal Code: | 660073031 |
Phone Number: | 8164195237 |
Fax Number: | |
NPI Enumeration Date: | 01/10/2012 |
NPI Last Update Date: | 01/10/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363AS0400X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Physician Assistant |
Taxonomy Specialization: | Surgical |
Taxonomy Definition: |