Provider Demographics
NPI:1043574767
Name:LEE, CATHRYN CHANDLER
Entity Type:Individual
Prefix:
First Name:CATHRYN
Middle Name:CHANDLER
Last Name:LEE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:CATHRYN
Other - Middle Name:SCOTT
Other - Last Name:CHANDLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNP
Mailing Address - Street 1:10903 NEW HAMPSHIRE AVE
Mailing Address - Street 2:WO22 RM6117
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20903-1058
Mailing Address - Country:US
Mailing Address - Phone:301-796-1394
Mailing Address - Fax:
Practice Address - Street 1:10903 NEW HAMPSHIRE AVE
Practice Address - Street 2:WO22 RM6117
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20903-1058
Practice Address - Country:US
Practice Address - Phone:301-796-1394
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-27
Last Update Date:2012-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDAC-000282363LA2200X
VA0024114171363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health