Provider Demographics
NPI:1861215477
Name:LEE, TAHNA LYNN (FNLP)
Entity type:Individual
Prefix:
First Name:TAHNA
Middle Name:LYNN
Last Name:LEE
Suffix:
Gender:F
Credentials:FNLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1146 N 1190 E
Mailing Address - Street 2:
Mailing Address - City:AMERICAN FORK
Mailing Address - State:UT
Mailing Address - Zip Code:84003-3509
Mailing Address - Country:US
Mailing Address - Phone:719-510-3079
Mailing Address - Fax:
Practice Address - Street 1:1146 N 1190 E
Practice Address - Street 2:
Practice Address - City:AMERICAN FORK
Practice Address - State:UT
Practice Address - Zip Code:84003-3509
Practice Address - Country:US
Practice Address - Phone:719-510-3079
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-02
Last Update Date:2024-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, Education