Provider Demographics
NPI:1265812408
Name:LEE, MELISSA MORTON (FNP)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:MORTON
Last Name:LEE
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:13570 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:TRENTON
Mailing Address - State:GA
Mailing Address - Zip Code:30752-2012
Mailing Address - Country:US
Mailing Address - Phone:706-956-2665
Mailing Address - Fax:706-657-2958
Practice Address - Street 1:929 SPRING CREEK RD STE 102
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37412-3974
Practice Address - Country:US
Practice Address - Phone:423-629-9743
Practice Address - Fax:423-629-9744
Is Sole Proprietor?:No
Enumeration Date:2015-06-03
Last Update Date:2023-12-12
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
GARN209627363LF0000X
TN34673363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000211956AMedicaid