Lee, Myrna
Lee, Myrna is an sole proprietor health care provider with primary practice located at 1740 E 17Th St Suite A, Idaho Falls ID 83404-6375. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Medical, which is considered as her primary health care specialty. Lee, Myrna can be contacted via phone (208) 346-7500.Contact Information
Primary practice address
1740 E 17Th St Suite A
Idaho Falls ID 83404-6375
Phone: (208) 346-7500
Fax: (208) 346-7501
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Medical | 363AM0700X | PA334 | Idaho |
Profile Details
| NPI number | 1194833111 |
|---|---|
| LBN Legal business name | Lee, Myrna |
| Credentials | Physician's Assistant Certified (PA-C) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Aug 29th, 2006 |
| Last updated | May 18th, 2009 - about 15 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1194833111 | NPPES |
| Idaho | MEDICAID | 806327800 |
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