Individual
MS. SHIRLEY LEE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
HIGHWAY 371 JUNCTION ROUTE 9, CROWNPOINT, NM 87313
(505) 786-5291
(505) 786-6440
Mailing address
PO BOX 358, CROWNPOINT, NM 87313-0358
(505) 786-5291
(505) 786-6440
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
NCCPA-790632
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
R5428
—
NM
Enumeration date
04/09/2007
Last updated
07/08/2007
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