Individual
HEATHER LEE TA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2800 E DESERT INN RD STE 100, LAS VEGAS, NV 89121-3609
(702) 731-1616
(702) 734-4900
Mailing address
2800 E DESERT INN RD STE 100, LAS VEGAS, NV 89121-3609
(702) 731-1616
(702) 734-4900
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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