Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LA2200X | Nurse Practitioner - Adult Health | 4704172619 | MI |
NPI | 1023204765 |
---|---|
Provider Name | Dr. Dorothy Susan Lee |
First Address | Bay City, MI 48708-5756 |
Second Address | Bay City, MI 48708-1916 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/09/2007 |
Last Update Date | 20/01/2017 |