Provider Demographics
NPI:1821284993
Name:LEE, NANCY MARIE (RN, MA, ANP-C)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:MARIE
Last Name:LEE
Suffix:
Gender:F
Credentials:RN, MA, ANP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:523 E 72ND ST
Mailing Address - Street 2:ROOM 509
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10021-4099
Mailing Address - Country:US
Mailing Address - Phone:212-606-1579
Mailing Address - Fax:212-744-5086
Practice Address - Street 1:523 E 72ND ST
Practice Address - Street 2:ROOM 509
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021-4099
Practice Address - Country:US
Practice Address - Phone:212-606-1579
Practice Address - Fax:212-744-5086
Is Sole Proprietor?:No
Enumeration Date:2007-09-21
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF304675-1163WG0000X, 163WM0705X, 163WX0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice
No163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical
No163WX0800XNursing Service ProvidersRegistered NurseOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYF304675-1OtherLICENSE NUMBER
NYF304675-1OtherLICENSE NUMBER