Provider Demographics
NPI:1902092638
Name:LEE, RITA A (NP)
Entity Type:Individual
Prefix:
First Name:RITA
Middle Name:A
Last Name:LEE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:1907 W MORRIS BLVD
Mailing Address - Street 2:SUITE B
Mailing Address - City:MORRISTOWN
Mailing Address - State:TN
Mailing Address - Zip Code:37813-3860
Mailing Address - Country:US
Mailing Address - Phone:423-587-2707
Mailing Address - Fax:423-587-3224
Practice Address - Street 1:1907 W MORRIS BLVD
Practice Address - Street 2:SUITE B
Practice Address - City:MORRISTOWN
Practice Address - State:TN
Practice Address - Zip Code:37813-3860
Practice Address - Country:US
Practice Address - Phone:423-587-2707
Practice Address - Fax:423-587-3224
Is Sole Proprietor?:No
Enumeration Date:2007-09-17
Last Update Date:2011-04-07
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TN5881363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3370247OtherMEDICARE GROUP
TN3370247OtherMEDICARE GROUP