Provider Demographics
NPI:1922236645
Name:LEE, RACHEL R
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:R
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 1:108 MITCHELL RIDGE PL
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31907-3788
Mailing Address - Country:US
Mailing Address - Phone:706-617-3047
Mailing Address - Fax:
Practice Address - Street 1:108 MITCHELL RIDGE PL
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31907-3788
Practice Address - Country:US
Practice Address - Phone:706-617-3047
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-01
Last Update Date:2009-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN160822163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse