Individual
MRS. TRICIA WILSON LEE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
8095 STRATFORD DR, IRVINGTON, AL 36544-4121
(251) 610-1995
Mailing address
8095 STRATFORD DR, IRVINGTON, AL 36544-4121
(251) 610-1995
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
1-087502
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1-087502
REGISTERED NURSE
AL
01
—
2021028810
ADULT GERONTOLOGY ACUTE CARE NURSE PRACTITIONER
—
Enumeration date
10/24/2021
Last updated
10/24/2021
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