Individual
CONNIE L LEE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
1370 S STATE ST STE B, SAN JACINTO, CA 92583-4922
(951) 791-3596
(951) 791-3397
Mailing address
29157 AZARA ST, MURRIETA, CA 92563-4429
(951) 816-2182
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
826304
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
826304
BOARD OF REGISTERED NURSING
CA
Enumeration date
12/01/2017
Last updated
12/01/2017
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