Provider Demographics
NPI:1255678884
Name:LEE, HEATHER MICHELLE (PA-C)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:MICHELLE
Last Name:LEE
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
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Mailing Address - Street 1:5306 NC HIGHWAY 55 STE 105
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27713-7812
Mailing Address - Country:US
Mailing Address - Phone:919-457-1517
Mailing Address - Fax:919-363-7697
Practice Address - Street 1:427 HARRISON AVE
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:NC
Practice Address - Zip Code:28734-2580
Practice Address - Country:US
Practice Address - Phone:828-524-7337
Practice Address - Fax:828-369-1340
Is Sole Proprietor?:No
Enumeration Date:2013-01-16
Last Update Date:2020-03-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC001004073363A00000X
NC363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA924304OtherWELLCARE
NC1255678884OtherDOCTORS DIRECT
1255678884OtherHEALTHNET FEDERAL SERVICES
GA003139252AOtherPEACHCARE 4 KIDS
NC3595612OtherUNITED HEALTHCARE
NCFH1101575OtherFIRST CAROLINA CARE
NC1255678884OtherHEALTHSMART
NC1255678884Medicaid
NC1396618OtherCOVENTRY OF THE CAROLINAS
NC9048984OtherAETNA
GA003139252AMedicaid
NC13286553OtherPHCS-MULTIPLAN
NC1255678884OtherHUMANA
NC1396618OtherWELLPATH
NC1772EOtherBCBS OF NC
NC264075OtherMEDCOST, LLC
NC2742033OtherCIGNA GREATWEST
NC4243028OtherCOVENTRY NATIONAL - COVENTRY PPO