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General NPI Number Information
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NPI Number | 1770314569
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Entity Type | Individual
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Provider Name | ANTHONY MICAH LEE APRN-CNP
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Gender | Male
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Dates
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Enumeration Date | 08/12/2024
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Last Update Date | 09/11/2024
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Provider Practice Location Address
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Address Line | 890 RICHMOND PLZ
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City | RICHMOND
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State | KY
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Zip | 40475-2564
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Country | US
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Telephone | 859-623-5155
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Fax |
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Provider Business Mailing Address
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Address Line | 2620 ELM HILL PIKE
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City | NASHVILLE
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State | TN
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Zip | 37214-3108
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Country | US
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Telephone | 615-425-4200
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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 | 4018810
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License Number State | KY
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