Healthcare Provider Details

I. General information

NPI: 1750207890
Provider Name (Legal Business Name): CASSIDY LEE NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/24/2026
Last Update Date: 06/24/2026
Certification Date: 06/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3100 WELLONS BLVD
NEW BERN NC
28562-5247
US

IV. Provider business mailing address

2231 10 MILE FORK RD
TRENTON NC
28585-8423
US

V. Phone/Fax

Practice location:
  • Phone: 252-634-9000
  • Fax:
Mailing address:
  • Phone: 252-665-5197
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberF06261470
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: