Provider Demographics
NPI:1083239313
Name:LEE, DANA MUSGROVE (NP)
Entity Type:Individual
Prefix:MS
First Name:DANA
Middle Name:MUSGROVE
Last Name:LEE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:DANAJOY
Other - Middle Name:MELISSA
Other - Last Name:VINCENT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:2305 E. DOUBLEGATE DR
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:GA
Mailing Address - Zip Code:31721
Mailing Address - Country:US
Mailing Address - Phone:229-886-8559
Mailing Address - Fax:229-375-0766
Practice Address - Street 1:211 NORTH JEFFERSON ST.
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:GA
Practice Address - Zip Code:31701
Practice Address - Country:US
Practice Address - Phone:229-302-1295
Practice Address - Fax:229-375-0766
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-12
Last Update Date:2024-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN190646363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily