Provider Demographics
NPI:1760182398
Name:LEE, ASHANTE LANELL
Entity Type:Individual
Prefix:
First Name:ASHANTE
Middle Name:LANELL
Last Name:LEE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:125 W SHARPNACK ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19119-4034
Mailing Address - Country:US
Mailing Address - Phone:215-203-2719
Mailing Address - Fax:
Practice Address - Street 1:125 W SHARPNACK ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19119-4034
Practice Address - Country:US
Practice Address - Phone:215-203-2719
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-02
Last Update Date:2023-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health