Individual
PENNY LAINE LEE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
7010 E CHAUNCEY LN STE 225, PHOENIX, AZ 85054-3117
(480) 585-5200
Mailing address
7010 E CHAUNCEY LN STE 225, PHOENIX, AZ 85054-3117
(602) 368-5014
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
AP4877
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
806811
—
AZ
Enumeration date
03/04/2013
Last updated
06/25/2021
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