Provider Demographics
NPI:1164673190
Name:LEE, ANN M (DO)
Entity Type:Individual
Prefix:DR
First Name:ANN
Middle Name:M
Last Name:LEE
Suffix:
Gender:F
Credentials:DO
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Mailing Address - Street 1:251 COUNTY ROAD 120
Mailing Address - Street 2:
Mailing Address - City:SAINT CLOUD
Mailing Address - State:MN
Mailing Address - Zip Code:56303-4872
Mailing Address - Country:US
Mailing Address - Phone:320-251-8181
Mailing Address - Fax:320-251-6942
Practice Address - Street 1:1301 33RD ST S
Practice Address - Street 2:
Practice Address - City:SAINT CLOUD
Practice Address - State:MN
Practice Address - Zip Code:56301-9668
Practice Address - Country:US
Practice Address - Phone:320-251-8181
Practice Address - Fax:320-251-6942
Is Sole Proprietor?:No
Enumeration Date:2008-10-08
Last Update Date:2023-03-27
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MN51394207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN1164673190Medicaid
MN080019932Medicare PIN