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Individual
SURA LEE
Active
Individual
SURA LEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSN, CRNP, CPNP-AC
Taxonomy
Speciality
Code
Description
License number
State
363LN0000X
Neonatal Nurse Practitioner
Primary
25NJ00879200
NJ
363LN0005X
Critical Care Neonatal Nurse Practitioner
SP012169
PA
Other
Enumeration date
12/23/2013
Last updated
04/11/2019
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