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General NPI Number Information
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NPI Number | 1255149225
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Entity Type | Individual
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Provider Name | LESLIE EUNICE SHEEHY LEE FNP-C
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Gender | Female
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Dates
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Enumeration Date | 12/23/2024
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Last Update Date | 01/16/2025
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Provider Practice Location Address
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Address Line | 7407 WAYZATA BLVD
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City | ST LOUIS PARK
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State | MN
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Zip | 55426-1619
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Country | US
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Telephone | 952-927-4556
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 16
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City | ELYSIAN
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State | MN
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Zip | 56028-0016
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Country | US
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Telephone | 651-334-9919
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 2058209
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License Number State | MN
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