Individual
VIVIAN LEE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1040 GRAND AVE # 5161, SAINT PAUL, MN 55105-3001
(651) 224-2155
Mailing address
1040 GRAND AVE # 5161, SAINT PAUL, MN 55105-3001
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
7660
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
7660
BON
MN
Enumeration date
12/07/2020
Last updated
12/09/2020
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