Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363L00000X | Nurse Practitioner | SP016253 | PA |
N | 363LP0200X | Nurse Practitioner - Pediatrics | R186330 | MD |
NPI | 1013306570 |
---|---|
Provider Name | Katherine Lee |
First Address | Hershey, PA 17033-0858 |
Second Address | Hershey, PA 17033-2360 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/01/2015 |
Last Update Date | 17/08/2016 |