Provider Demographics
NPI:1225546690
Name:LEE, LATOYA BO'NEE (DNP,)
Entity Type:Individual
Prefix:
First Name:LATOYA
Middle Name:BO'NEE
Last Name:LEE
Suffix:
Gender:F
Credentials:DNP,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1030 MONARCH ST
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40513-1843
Mailing Address - Country:US
Mailing Address - Phone:859-296-3141
Mailing Address - Fax:
Practice Address - Street 1:161 PROSPEROUS PL STE 100
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40509-1898
Practice Address - Country:US
Practice Address - Phone:859-368-0609
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-01-18
Last Update Date:2018-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3012007363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty