Provider Demographics
NPI:1205512977
Name:LEE, MEI CHING (A-GNP-C)
Entity type:Individual
Prefix:
First Name:MEI CHING
Middle Name:
Last Name:LEE
Suffix:
Gender:F
Credentials:A-GNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6483 TYDINGS RD
Mailing Address - Street 2:
Mailing Address - City:ELDERSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:21784-6142
Mailing Address - Country:US
Mailing Address - Phone:443-536-3853
Mailing Address - Fax:
Practice Address - Street 1:1645 LIBERTY RD STE 204
Practice Address - Street 2:
Practice Address - City:ELDERSBURG
Practice Address - State:MD
Practice Address - Zip Code:21784-6542
Practice Address - Country:US
Practice Address - Phone:410-795-7737
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-26
Last Update Date:2023-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDAG06230196363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health