Provider Demographics
NPI:1700223823
Name:LEE, KARREN ANNTONETT (RN)
Entity Type:Individual
Prefix:MS
First Name:KARREN
Middle Name:ANNTONETT
Last Name:LEE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MISS
Other - First Name:KARREN
Other - Middle Name:ANNTONETT
Other - Last Name:ANDERSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:10308 MISTRAL DR NW
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87114-3210
Mailing Address - Country:US
Mailing Address - Phone:352-228-1220
Mailing Address - Fax:
Practice Address - Street 1:10308 MISTRAL DR NW
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87114-3210
Practice Address - Country:US
Practice Address - Phone:352-228-1220
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-05-30
Last Update Date:2023-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM2022008042363LP0808X
FLRN9200269163WD0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163WD0400XNursing Service ProvidersRegistered NurseDiabetes Educator