Provider Demographics
NPI:1902427685
Name:MYERS, LEE ELIZABETH (DNP,MSN, FNP (BC))
Entity Type:Individual
Prefix:DR
First Name:LEE
Middle Name:ELIZABETH
Last Name:MYERS
Suffix:
Gender:F
Credentials:DNP,MSN, FNP (BC)
Other - Prefix:
Other - First Name:LEE
Other - Middle Name:E
Other - Last Name:BELLIVEAU-MYERS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RN
Mailing Address - Street 1:799 HOPE ST
Mailing Address - Street 2:
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02906-3635
Mailing Address - Country:US
Mailing Address - Phone:401-316-4919
Mailing Address - Fax:380-203-1341
Practice Address - Street 1:8 ROSEWOOD ST # 1
Practice Address - Street 2:
Practice Address - City:PAWTUCKET
Practice Address - State:RI
Practice Address - Zip Code:02860-4427
Practice Address - Country:US
Practice Address - Phone:401-316-4919
Practice Address - Fax:380-203-1341
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-04
Last Update Date:2021-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIAPRN02228363LF0000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily