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Individual

RENEE LEE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
FNP

Contact information

Practice address
301 MOUNTAIN ST E, CAVALIER, ND 58220-4015
(701) 265-6307
Mailing address
PO BOX 380, CAVALIER, ND 58220-0380

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PAC0055
ND

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
MEDICAID ID
ND
Enumeration date
01/29/2007
Last updated
07/09/2007
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