MEDICARE: LEE'S MEDICAL PRACTICE AND CONSULTING, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP0808X	Psychiatric/Mental Health Nurse Practitioner
2	363LF0000X	Family Nurse Practitioner

General Provider Information

NPI Number	:	1023828738
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LEE'S MEDICAL PRACTICE AND CONSULTING, LLC

Provider Business Mailing Address
First Line	:	2007 FENDLEY DR
Second Line	:
City	:	NORTH LITTLE ROCK
State	:	AR
Zip	:	72114-1806
Country	:	US
Telephone Number	:	501-246-3261
Fax Number	:	501-916-2776

Provider Business Practice Location Address
First Line	:	2007 FENDLEY DR
Second Line	:
City	:	NORTH LITTLE ROCK
State	:	AR
Zip	:	72114-1806
Country	:	US
Telephone Number	:	501-246-3261
Fax Number	:	501-916-2776

Authorized Official
Title or Position	:	DNP, PMHMP-BC, FNP-C, APRN
Name	:	DR. SHERITA ANTOINETTE LEE
Credential	:
Telephone Number	:	501-246-3261

Provider Enumeration Date	:	01/14/2025
Last Update Date	:	12/06/2025

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