Individual
MISS LISA RENAE LEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
7 INDEPENDENCE PT STE 300, GREENVILLE, SC 29615-4569
(864) 522-3700
(864) 522-3705
Mailing address
300 E MCBEE AVE FL 4, GREENVILLE, SC 29601-2842
(864) 522-8603
(803) 296-7330
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
159082
GA
367500000X
Certified Registered Nurse Anesthetist
Primary
4056
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GAN851
—
SC
01
—
Q46530
MEDICARE
SC
Enumeration date
04/04/2008
Last updated
01/15/2025
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