Provider Demographics
NPI:1972890390
Name:MACIK, LEE
Entity Type:Individual
Prefix:
First Name:LEE
Middle Name:
Last Name:MACIK
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 1:314 MCCONNELL DR
Mailing Address - Street 2:
Mailing Address - City:LYONS
Mailing Address - State:CO
Mailing Address - Zip Code:80540-3805
Mailing Address - Country:US
Mailing Address - Phone:303-823-6999
Mailing Address - Fax:
Practice Address - Street 1:314 MCCONNELL DR
Practice Address - Street 2:
Practice Address - City:LYONS
Practice Address - State:CO
Practice Address - Zip Code:80540-3805
Practice Address - Country:US
Practice Address - Phone:303-823-6999
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-07-06
Last Update Date:2011-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula