Provider Demographics
NPI:1730302233
Name:LEE, NICOLE SHEREE (CRNP)
Entity type:Individual
Prefix:MRS
First Name:NICOLE
Middle Name:SHEREE
Last Name:LEE
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:356 GRAYTON DR
Mailing Address - Street 2:
Mailing Address - City:SMYRNA
Mailing Address - State:DE
Mailing Address - Zip Code:19977-4466
Mailing Address - Country:US
Mailing Address - Phone:215-380-8027
Mailing Address - Fax:
Practice Address - Street 1:301 OCEAN VIEW BLVD
Practice Address - Street 2:
Practice Address - City:LEWES
Practice Address - State:DE
Practice Address - Zip Code:19958-1269
Practice Address - Country:US
Practice Address - Phone:302-645-4664
Practice Address - Fax:302-645-5667
Is Sole Proprietor?:No
Enumeration Date:2007-04-11
Last Update Date:2025-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DELG-0011577363LF0000X
PAF10190854363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily