MEDICARE: MS. LISA LEES FNP

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	363LF0000X	Family Nurse Practitioner	194048	CO

General Provider Information

NPI Number	:	1891843363
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. LISA LEES FNP

Provider Business Mailing Address
First Line	:	1278 POMEGRANATE LN
Second Line	:
City	:	GOLDEN
State	:	CO
Zip	:	80401-9222
Country	:	US
Telephone Number	:	303-718-2955
Fax Number	:

Provider Business Practice Location Address
First Line	:	1278 POMEGRANATE LN
Second Line	:
City	:	GOLDEN
State	:	CO
Zip	:	80401-9222
Country	:	US
Telephone Number	:	303-718-2955
Fax Number	:

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

Provider Enumeration Date	:	01/08/2007
Last Update Date	:	03/09/2009

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