Provider Demographics
NPI:1386178523
Name:LEE, ALEXANDRIA PAIGE POTRATZ (AUD)
Entity Type:Individual
Prefix:DR
First Name:ALEXANDRIA
Middle Name:PAIGE POTRATZ
Last Name:LEE
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:DR
Other - First Name:ALEXANDRIA
Other - Middle Name:PAIGE
Other - Last Name:POTRATZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:AUD
Mailing Address - Street 1:2311 DELANEY AVE
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28403-6012
Mailing Address - Country:US
Mailing Address - Phone:910-762-8754
Mailing Address - Fax:910-762-0778
Practice Address - Street 1:63 HAYWOOD PARK DR
Practice Address - Street 2:
Practice Address - City:CLYDE
Practice Address - State:NC
Practice Address - Zip Code:28721-4404
Practice Address - Country:US
Practice Address - Phone:828-593-4327
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-04-14
Last Update Date:2023-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC13817237600000X, 231H00000X, 237700000X, 231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
No237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
6507187OtherUNITED HEALTHCARE
6507187OtherUNITED HEALTHCARE