Provider Demographics
NPI:1114445145
Name:LEE, KATLYN LANE (OD)
Entity Type:Individual
Prefix:DR
First Name:KATLYN
Middle Name:LANE
Last Name:LEE
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1821 FLORENCE PIKE STE 1
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:41005-7942
Mailing Address - Country:US
Mailing Address - Phone:589-586-3937
Mailing Address - Fax:859-689-6232
Practice Address - Street 1:1821 FLORENCE PIKE STE 1
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:KY
Practice Address - Zip Code:41005-7942
Practice Address - Country:US
Practice Address - Phone:589-586-3937
Practice Address - Fax:859-689-6232
Is Sole Proprietor?:No
Enumeration Date:2017-08-30
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY2066DT152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist