Provider Demographics
NPI:1346017530
Name:LEE, ALICIA (PA-C)
Entity Type:Individual
Prefix:
First Name:ALICIA
Middle Name:
Last Name:LEE
Suffix:
Gender:F
Credentials:PA-C
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Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1701 N GREEN VALLEY PKWY STE 4B
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89074-5886
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1701 N GREEN VALLEY PKWY STE 4B
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89074-5886
Practice Address - Country:US
Practice Address - Phone:702-349-6539
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-07
Last Update Date:2024-04-07
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant