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General NPI Number Information
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NPI Number | 1992524284
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Entity Type | Individual
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Provider Name | ERICA LEE RN
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Gender | Female
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Dates
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Enumeration Date | 10/04/2024
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Last Update Date | 10/04/2024
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Provider Practice Location Address
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Address Line | 2022 BATTERY PARK DR.
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City | GLENDALE
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State | KY
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Zip | 42740
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Country | US
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Telephone | 901-499-9569
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Fax |
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Provider Business Mailing Address
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Address Line | 2022 BATTERY PARK DR.
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City | GLENDALE
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State | KY
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Zip | 42740
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Country | US
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Telephone | 901-499-9569
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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 | 163WX0106X
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Taxonomy Name | Occupational Health Registered Nurse
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License Number | 1108360
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License Number State | KY
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