Provider Demographics
NPI:1255149225
Name:LEE, LESLIE EUNICE SHEEHY (FNP-C)
Entity type:Individual
Prefix:
First Name:LESLIE
Middle Name:EUNICE SHEEHY
Last Name:LEE
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:LESLIE
Other - Middle Name:EUNICE
Other - Last Name:SHEEHY LEE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:PO BOX 16
Mailing Address - Street 2:
Mailing Address - City:ELYSIAN
Mailing Address - State:MN
Mailing Address - Zip Code:56028-0016
Mailing Address - Country:US
Mailing Address - Phone:651-334-9919
Mailing Address - Fax:
Practice Address - Street 1:7407 WAYZATA BLVD
Practice Address - Street 2:
Practice Address - City:ST LOUIS PARK
Practice Address - State:MN
Practice Address - Zip Code:55426-1619
Practice Address - Country:US
Practice Address - Phone:952-927-4556
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-23
Last Update Date:2025-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN2058209207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine