Healthcare Provider Details

I. General information

NPI: 1023828738
Provider Name (Legal Business Name): LEE'S MEDICAL PRACTICE AND CONSULTING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/14/2025
Last Update Date: 12/06/2025
Certification Date: 12/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2007 FENDLEY DR
NORTH LITTLE ROCK AR
72114-1806
US

IV. Provider business mailing address

2007 FENDLEY DR
NORTH LITTLE ROCK AR
72114-1806
US

V. Phone/Fax

Practice location:
  • Phone: 501-246-3261
  • Fax: 501-916-2776
Mailing address:
  • Phone: 501-246-3261
  • Fax: 501-916-2776

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: DR. SHERITA ANTOINETTE LEE
Title or Position: DNP, PMHMP-BC, FNP-C, APRN
Credential:
Phone: 501-246-3261