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General NPI Number Information
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NPI Number | 1215493945
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Entity Type | Individual
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Provider Name | ELIZABETH HARRIS LEE LPN
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Gender | Female
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Dates
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Enumeration Date | 02/19/2019
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Last Update Date | 02/19/2019
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Provider Practice Location Address
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Address Line | 2470 MALL DR STE C
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City | NORTH CHARLESTON
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State | SC
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Zip | 29406-6514
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Country | US
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Telephone | 843-207-4721
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Fax | 843-207-4727
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Provider Business Mailing Address
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Address Line | 252 WESTBROOKE RD
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City | SUMMERVILLE
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State | SC
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Zip | 29486-8354
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Country | US
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Telephone | 843-276-9100
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 164W00000X
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Taxonomy Name | Licensed Practical Nurse
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License Number | 47244
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License Number State | SC
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