Individual
HEATHER LEE TA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
PA 1132
NV
363AS0400X
Surgical Physician Assistant
Primary
PA1132
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PA1132
NV MEDICAL LICENSE
NV
Enumeration date
09/29/2008
Last updated
02/28/2022
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