MEDICARE: MS. ANDREA DANIELLE LEE NP

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	95036065	CA
2	163W00000X	Registered Nurse	RN0000182403	TN

General Provider Information

NPI Number	:	1700167681
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. ANDREA DANIELLE LEE NP

Provider Business Mailing Address
First Line	:	1324 W MAIN ST
Second Line	:
City	:	FRANKLIN
State	:	TN
Zip	:	37064-3784
Country	:	US
Telephone Number	:	615-794-1542
Fax Number	:

Provider Business Practice Location Address
First Line	:	4546 EL CAMINO REAL STE B7
Second Line	:
City	:	LOS ALTOS
State	:	CA
Zip	:	94022-1069
Country	:	US
Telephone Number	:	866-362-4246
Fax Number	:	650-260-6030

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

Provider Enumeration Date	:	09/06/2011
Last Update Date	:	08/13/2025

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