Provider Demographics
NPI:1851936371
Name:LEE, LINDA CHARLOTTE (LVN)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:CHARLOTTE
Last Name:LEE
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:175 COUNTY ROAD 6721
Mailing Address - Street 2:
Mailing Address - City:NATALIA
Mailing Address - State:TX
Mailing Address - Zip Code:78059-2123
Mailing Address - Country:US
Mailing Address - Phone:830-444-1395
Mailing Address - Fax:
Practice Address - Street 1:175 COUNTY ROAD 6721
Practice Address - Street 2:
Practice Address - City:NATALIA
Practice Address - State:TX
Practice Address - Zip Code:78059-2123
Practice Address - Country:US
Practice Address - Phone:830-444-1395
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-07
Last Update Date:2019-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253J00000XAgenciesFoster Care Agency