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General NPI Number Information
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NPI Number | 1730425943
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Entity Type | Individual
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Provider Name | NANTAWADEE LEE
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Gender | Female
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Dates
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Enumeration Date | 12/14/2012
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Last Update Date | 12/14/2012
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Provider Practice Location Address
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Address Line | 64030 HIGHWAY 434
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City | LACOMBE
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State | LA
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Zip | 70445-3456
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Country | US
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Telephone | 985-690-7500
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Fax |
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Provider Business Mailing Address
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Address Line | 64030 HWY 434
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City | LACOMBE
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State | LA
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Zip | 70445
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Country | US
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Telephone | 985-690-5900
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 163W00000X
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License Number State | LA
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Taxonomy #2
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Taxonomy Code | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | 363LA2100X
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License Number State | LA
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