Provider Demographics
NPI:1295121135
Name:LEE, DAWN E (APRN)
Entity type:Individual
Prefix:MS
First Name:DAWN
Middle Name:E
Last Name:LEE
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 W THAMES ST
Mailing Address - Street 2:BUILDING 301
Mailing Address - City:NORWICH
Mailing Address - State:CT
Mailing Address - Zip Code:06360-7151
Mailing Address - Country:US
Mailing Address - Phone:860-859-4626
Mailing Address - Fax:
Practice Address - Street 1:401 W THAMES ST
Practice Address - Street 2:BUILDING 301
Practice Address - City:NORWICH
Practice Address - State:CT
Practice Address - Zip Code:06360-7151
Practice Address - Country:US
Practice Address - Phone:860-859-4626
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-04-07
Last Update Date:2015-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT005637363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner