Provider Demographics
NPI:1144521220
Name:LEE, MISTY-ANNE REBECCA (PHARMD)
Entity type:Individual
Prefix:DR
First Name:MISTY-ANNE
Middle Name:REBECCA
Last Name:LEE
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:920 SW SOLDIER CT
Mailing Address - Street 2:
Mailing Address - City:LEES SUMMIT
Mailing Address - State:MO
Mailing Address - Zip Code:64082-4948
Mailing Address - Country:US
Mailing Address - Phone:816-941-2162
Mailing Address - Fax:816-941-2635
Practice Address - Street 1:650 CARONDELET DR
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64114-4672
Practice Address - Country:US
Practice Address - Phone:816-941-2162
Practice Address - Fax:816-941-2635
Is Sole Proprietor?:No
Enumeration Date:2010-11-05
Last Update Date:2010-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2007002493183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist