Provider Demographics
NPI:1952872160
Name:LEE, DAVID (FNP-BC, MSN, MN, RN)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:
Last Name:LEE
Suffix:
Gender:M
Credentials:FNP-BC, MSN, MN, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:370 E MARKET ST
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44304-1526
Mailing Address - Country:US
Mailing Address - Phone:234-312-3607
Mailing Address - Fax:
Practice Address - Street 1:370 E MARKET ST
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44304-1526
Practice Address - Country:US
Practice Address - Phone:234-312-3609
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-12-16
Last Update Date:2021-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN.443733163W00000X
OHAPRN.CNP.024527363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse