MEDICARE: GEORGE B LEE CRNA

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	174400000X	Specialist	RN331712L	PA

General Provider Information

NPI Number	:	1407826779
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GEORGE B LEE CRNA

Provider Business Mailing Address
First Line	:	349 CHECHAK ROAD
Second Line	:
City	:	KITTANNING
State	:	PA
Zip	:	16201
Country	:	US
Telephone Number	:	724-545-2740
Fax Number	:

Provider Business Practice Location Address
First Line	:	1622 LOCUST ST
Second Line	:
City	:	PITTSBURGH
State	:	PA
Zip	:	15219-5924
Country	:	US
Telephone Number	:	412-232-8111
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/26/2006
Last Update Date	:	09/12/2024

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