Individual
MS. PHYLLIS J LEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNP
Contact information
Practice address
180 WSF TATUM DR, HATTIESBURG, MS 39401-7700
(601) 450-0805
(601) 450-0806
Mailing address
PO BOX 1729, HATTIESBURG, MS 39403-1729
(601) 545-8700
(601) 450-2493
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R867439
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
06072709
—
MS
01
—
5883830
CIGNA
MS
01
—
P00828627
RAILROAD MEDICARE
MS
Enumeration date
05/02/2008
Last updated
02/07/2017
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