Individual
MS. LINDA LEE I
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP, PA
Contact information
Practice address
19021 US HIGHWAY 285, LA JARA, CO 81140-9410
(719) 274-5121
Mailing address
19021 US HIGHWAY 285, LA JARA, CO 81140-9410
(719) 274-5121
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
125926
CO
363L00000X
Nurse Practitioner
431047
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
19054751
—
CO
Enumeration date
10/03/2005
Last updated
03/29/2016
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