Individual
BRIDGET ODOM LEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1541 KINGS HWY, SHREVEPORT, LA 71103-4228
(318) 626-0000
Mailing address
1512 W KIRBY PL, SHREVEPORT, LA 71103-3822
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
206766
LA
Other
Enumeration date
07/05/2019
Last updated
07/05/2019
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