Provider Demographics
NPI:1922417591
Name:LEE, MONICA (CNP)
Entity Type:Individual
Prefix:
First Name:MONICA
Middle Name:
Last Name:LEE
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:DR
Other - First Name:MONICA
Other - Middle Name:
Other - Last Name:LEE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DNP, FNP-BC
Mailing Address - Street 1:5450 FRANTZ RD STE 360
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:OH
Mailing Address - Zip Code:43016-4141
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5193 W BROAD ST STE 200
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43228
Practice Address - Country:US
Practice Address - Phone:614-544-1450
Practice Address - Fax:614-533-0136
Is Sole Proprietor?:No
Enumeration Date:2014-08-07
Last Update Date:2019-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.021078363LF0000X
FLSELF363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0257064Medicaid