Individual
LAURA MAE LEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
60 HOSPITAL RD, NEWNAN, GA 30263-1210
(269) 369-5639
Mailing address
20 DEER RUN TRL, SHARPSBURG, GA 30277-1994
(269) 369-5639
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
209005864
IL
367500000X
Certified Registered Nurse Anesthetist
28108068A
IN
367500000X
Certified Registered Nurse Anesthetist
4704173262
MI
367500000X
Certified Registered Nurse Anesthetist
RN201155
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1609812205
BLUE CROSS BLUE SHEILD
GA
05
—
355570547D
—
GA
Enumeration date
06/21/2006
Last updated
10/14/2010
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