Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363L00000X | Nurse Practitioner | 11003995 | FL |
N | 363L00000X | Nurse Practitioner | RN1002036 | DC |
N | 363LA2100X | Nurse Practitioner - Acute Care | 657084 | TX |
N | 363LA2100X | Nurse Practitioner - Acute Care | APN0000013553 | TN |
N | 363LF0000X | Nurse Practitioner - Family Medicine | 5010186 | NC |
NPI | 1043285091 |
---|---|
Provider Name | Shawn M. Lee |
First Address | Freeport, FL 32439-6573 |
Second Address | Panama City Beach, FL 32413-5409 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/02/2006 |
Last Update Date | 26/10/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
410059000 | (05) | DC |