Provider Demographics
NPI:1013971944
Name:LEE, LINDA M (CNS)
Entity type:Individual
Prefix:
First Name:LINDA
Middle Name:M
Last Name:LEE
Suffix:
Gender:F
Credentials:CNS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2150 NOLL DR
Mailing Address - Street 2:SUITE 200
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17603-7604
Mailing Address - Country:US
Mailing Address - Phone:717-735-1972
Mailing Address - Fax:717-735-2004
Practice Address - Street 1:2150 NOLL DR
Practice Address - Street 2:SUITE 200
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17603-7604
Practice Address - Country:US
Practice Address - Phone:717-735-1972
Practice Address - Fax:717-735-2004
Is Sole Proprietor?:No
Enumeration Date:2006-04-17
Last Update Date:2013-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP013044363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
070064Medicare ID - Type Unspecified
P90268Medicare UPIN