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General NPI Number Information
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NPI Number | 1265242465
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Entity Type | Individual
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Provider Name | AMANDA LEE FNP-C
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Gender | Female
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Dates
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Enumeration Date | 01/09/2025
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Last Update Date | 01/09/2025
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Provider Practice Location Address
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Address Line | 2200 JEFFERSON HWY
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City | JEFFERSON
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State | LA
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Zip | 70121-3822
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Country | US
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Telephone | 504-837-3144
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Fax |
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Provider Business Mailing Address
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Address Line | 32 SWITCH RD
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City | CARRIERE
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State | MS
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Zip | 39426-8953
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Country | US
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Telephone | 601-337-1921
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 239418
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License Number State | LA
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