Provider Demographics
NPI:1720040363
Name:LEE, PATRICIA J (NURSE PRACTIONER)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:J
Last Name:LEE
Suffix:
Gender:F
Credentials:NURSE PRACTIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4330 WORNALL RD
Mailing Address - Street 2:MED PLAZA II, 4TH FLOOR
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64111-3217
Mailing Address - Country:US
Mailing Address - Phone:816-531-0930
Mailing Address - Fax:816-753-2671
Practice Address - Street 1:4330 WORNALL RD
Practice Address - Street 2:MED PLAZA II, 4TH FLOOR
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64111-3217
Practice Address - Country:US
Practice Address - Phone:816-531-0930
Practice Address - Fax:816-753-2671
Is Sole Proprietor?:No
Enumeration Date:2006-04-06
Last Update Date:2011-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO207RR0500X207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS424095OtherBCBS
P17816Medicare UPIN
KS424095OtherBCBS