Provider Demographics
NPI:1134157654
Name:LEE, PATTI HOOKS IV (ANP)
Entity type:Individual
Prefix:MRS
First Name:PATTI
Middle Name:HOOKS
Last Name:LEE
Suffix:IV
Gender:F
Credentials:ANP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1302 MEDICAL CENTER DR
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28401-7503
Mailing Address - Country:US
Mailing Address - Phone:910-343-9800
Mailing Address - Fax:910-343-8650
Practice Address - Street 1:1302 MEDICAL CENTER DR
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28401-7503
Practice Address - Country:US
Practice Address - Phone:910-343-9800
Practice Address - Fax:910-343-8650
Is Sole Proprietor?:No
Enumeration Date:2006-06-30
Last Update Date:2008-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC900121363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC2591940Medicare ID - Type UnspecifiedMEDICARE INDIVIDUAL #
NCS75949Medicare UPIN