Provider Demographics
NPI:1255578423
Name:LEE, COLLEEN S (CPNP)
Entity type:Individual
Prefix:
First Name:COLLEEN
Middle Name:S
Last Name:LEE
Suffix:
Gender:F
Credentials:CPNP
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Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:DEPARTMENT OF PEDIATRICS
Mailing Address - Street 2:MSC10 5590 1 UNIVERSITY OF NEW MEXICO
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87131-0001
Mailing Address - Country:US
Mailing Address - Phone:505-272-4461
Mailing Address - Fax:505-272-8699
Practice Address - Street 1:DEPARTMENT OF PEDIATRICS
Practice Address - Street 2:MSC10 5590 1 UNIVERSITY OF NEW MEXICO
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87131-0001
Practice Address - Country:US
Practice Address - Phone:505-272-4461
Practice Address - Fax:505-272-8699
Is Sole Proprietor?:No
Enumeration Date:2009-01-09
Last Update Date:2024-03-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NMR25624363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics