Provider Demographics
NPI:1891843363
Name:LEES, LISA (FNP)
Entity Type:Individual
Prefix:MS
First Name:LISA
Middle Name:
Last Name:LEES
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1278 POMEGRANATE LN
Mailing Address - Street 2:
Mailing Address - City:GOLDEN
Mailing Address - State:CO
Mailing Address - Zip Code:80401-9222
Mailing Address - Country:US
Mailing Address - Phone:303-718-2955
Mailing Address - Fax:
Practice Address - Street 1:1278 POMEGRANATE LN
Practice Address - Street 2:
Practice Address - City:GOLDEN
Practice Address - State:CO
Practice Address - Zip Code:80401-9222
Practice Address - Country:US
Practice Address - Phone:303-718-2955
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-08
Last Update Date:2009-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO194048363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MSP71790Medicare UPIN