Individual
TESSA M LEE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
10001 LILE DR, LITTLE ROCK, AR 72205-6217
(501) 552-0500
(501) 320-1620
Mailing address
10001 LILE DR, LITTLE ROCK, AR 72205-6217
(501) 552-0500
(501) 320-1620
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
217731798
—
AR
01
—
PA
PA LICENSE
AR
Enumeration date
10/10/2016
Last updated
03/08/2021
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