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Individual

TERRY LEE LEX

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CRNA

Contact information

Practice address
49 TUNNEL RD, STE 103, POTTSVILLE, PA 17901-0049
(570) 622-6520
(570) 622-6525
Mailing address
PO BOX 67, WESTON, PA 18256-0067
(570) 956-1523
(570) 384-4177

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
RN306828L
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1020960950001
PA
01
P00135538
RR MEDICARE
PA
01
P00736830
RR MEDICARE
PA
Enumeration date
08/10/2005
Last updated
04/27/2015
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