Individual
TIMICA LASHAI LEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
3600 30TH ST, DES MOINES, IA 50310-5753
(515) 865-1127
Mailing address
3012 E SPRING ST, DES MOINES, IA 50320-2033
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
P56716
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
20080819
NPI
—
Enumeration date
10/19/2017
Last updated
10/19/2017
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