MEDICARE: ALISHA E LEE R.N.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163WL0100X	Lactation Consultant (Registered Nurse)	685302	CA

General Provider Information

NPI Number	:	1306262589
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALISHA E LEE R.N.

Provider Business Mailing Address
First Line	:	4912 VIRGINIA WAY
Second Line	:
City	:	SACRAMENTO
State	:	CA
Zip	:	95822-2151
Country	:	US
Telephone Number	:	406-581-2313
Fax Number	:

Provider Business Practice Location Address
First Line	:	4912 VIRGINIA WAY
Second Line	:
City	:	SACRAMENTO
State	:	CA
Zip	:	95822-2151
Country	:	US
Telephone Number	:	406-581-2313
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/11/2014
Last Update Date	:	03/11/2014

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Directions to “ ALISHA E LEE R.N.” Practice Location

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