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NPI Code Detail

MEDICARE: ALEXIS LEE

MEDICARE: ALEXIS LEE
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
1363L00000XNurse Practitioner907542MS

General Provider Information

NPI Number : 1578406260
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALEXIS LEE
Provider Business Mailing Address
First Line : 70 MEDICAL PLZ
Second Line :
City : EUPORA
State : MS
Zip : 39744-4018
Country : US
Telephone Number : 662-258-6221
Fax Number :
Provider Business Practice Location Address
First Line : 70 MEDICAL PLZ
Second Line :
City : EUPORA
State : MS
Zip : 39744-4018
Country : US
Telephone Number : 662-258-6221
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/09/2026
Last Update Date : 04/09/2026

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Directions to “ ALEXIS LEE ” Practice Location

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