Provider Demographics
NPI:1760477053
Name:LEE, SHARON KAYE (FNP-C)
Entity Type:Individual
Prefix:
First Name:SHARON
Middle Name:KAYE
Last Name:LEE
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2195 ALLENTOWN RD
Mailing Address - Street 2:
Mailing Address - City:LIMA
Mailing Address - State:OH
Mailing Address - Zip Code:45805-1705
Mailing Address - Country:US
Mailing Address - Phone:419-227-2245
Mailing Address - Fax:419-229-1573
Practice Address - Street 1:2195 ALLENTOWN RD
Practice Address - Street 2:
Practice Address - City:LIMA
Practice Address - State:OH
Practice Address - Zip Code:45805-1705
Practice Address - Country:US
Practice Address - Phone:419-227-2245
Practice Address - Fax:419-229-1573
Is Sole Proprietor?:No
Enumeration Date:2005-09-13
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHNP03673363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH1760477053OtherPECOS
OHLENP33482OtherMEDICARE PTAN
OH2183739Medicaid
OHLENP33482OtherMEDICARE PTAN
OHNP33481Medicare PIN