Individual
PAT RANDOLPH LEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PED NURSE PRAC CERT
Contact information
Practice address
11990 JACKSON ST, CLINTON, LA 70722
(225) 683-5292
(225) 683-3411
Mailing address
PO BOX 395, CLINTON, LA 70722-0395
(225) 683-5292
(225) 683-3411
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
AP01814
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1689742
—
LA
Enumeration date
08/12/2006
Last updated
01/23/2020
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