Provider Demographics
NPI:1417310905
Name:LEE, RACHEL DENISE (BSN, RN)
Entity Type:Individual
Prefix:MISS
First Name:RACHEL
Middle Name:DENISE
Last Name:LEE
Suffix:
Gender:F
Credentials:BSN, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1770 COUNTY ROAD 4683
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:TX
Mailing Address - Zip Code:75551-8028
Mailing Address - Country:US
Mailing Address - Phone:903-244-1269
Mailing Address - Fax:
Practice Address - Street 1:1770 COUNTY ROAD 4683
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:TX
Practice Address - Zip Code:75551-8028
Practice Address - Country:US
Practice Address - Phone:903-244-1269
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-04-01
Last Update Date:2016-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9428660163W00000X
TX797484163W00000X
CA95054248163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse