Provider Demographics
NPI:1134543614
Name:LEES, MEGHAN MARIE (CRNA)
Entity type:Individual
Prefix:
First Name:MEGHAN
Middle Name:MARIE
Last Name:LEES
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:MEGHAN
Other - Middle Name:
Other - Last Name:FITZHENRY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:209 S MAIN ST
Mailing Address - Street 2:STE 170
Mailing Address - City:POPLAR BLUFF
Mailing Address - State:MO
Mailing Address - Zip Code:63901-5831
Mailing Address - Country:US
Mailing Address - Phone:573-686-5550
Mailing Address - Fax:573-686-2139
Practice Address - Street 1:4608 WATERLOO DRIV
Practice Address - Street 2:STE 170
Practice Address - City:COLUMBIA
Practice Address - State:MO
Practice Address - Zip Code:65202
Practice Address - Country:US
Practice Address - Phone:314-306-7902
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-05
Last Update Date:2023-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2014000684367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered