Individual
NICOLE C LEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
489 STATE ST, BANGOR, ME 04401-6616
(207) 973-6670
(207) 973-5226
Mailing address
489 STATE ST, PO BOX 404, BANGOR, ME 04401-6616
(207) 973-6670
(207) 973-5226
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA768
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
261710099
—
ME
Enumeration date
09/24/2006
Last updated
10/25/2017
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