MEDICARE: MR. LEE MCPHAIL NAIL CRNP

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	363LF0000X	Family Nurse Practitioner	1-040173	AL

General Provider Information

NPI Number	:	1932137940
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. LEE MCPHAIL NAIL CRNP

Provider Business Mailing Address
First Line	:	1957 HOOVER CT
Second Line	:	SUITE 218
City	:	HOOVER
State	:	AL
Zip	:	35226-3622
Country	:	US
Telephone Number	:	205-243-3491
Fax Number	:	205-978-1445

Provider Business Practice Location Address
First Line	:	1957 HOOVER CT
Second Line	:	SUITE 218
City	:	HOOVER
State	:	AL
Zip	:	35226-3622
Country	:	US
Telephone Number	:	205-243-3491
Fax Number	:	205-978-1445

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

Provider Enumeration Date	:	06/29/2006
Last Update Date	:	07/08/2007

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