Lee, Phyllis J

Lee, Phyllis J is an individual health care provider with primary practice located at 180 Wsf Tatum Dr , Hattiesburg MS 39401-7700. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Lee, Phyllis J can be contacted via phone (601) 450-0805.

Contact Information

Primary practice address
180 Wsf Tatum Dr Hattiesburg MS 39401-7700
Phone: (601) 450-0805
Fax: (601) 450-0806
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X R867439 Mississippi

Profile Details

NPI number 1447426192
LBN Legal business name Lee, Phyllis J
Credentials Certified Nurse Practitioner (CNP)
Entity Individual
Sole proprietor 1 No
Enumeration date May 2nd, 2008
Last updated Feb 7th, 2017 - about 7 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1447426192 NPPES
Mississippi MEDICAID 06072709
Mississippi Other P00828627
Mississippi Other 5883830

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