Individual
TRAVIS ALLEN LEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
2095 HENRY TECKLENBURG DR, CHARLESTON, SC 29414-5733
(843) 402-1436
Mailing address
PO BOX 603484, CHARLOTTE, NC 28260-3484
(803) 765-1838
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
0000185485
TN
367500000X
Certified Registered Nurse Anesthetist
Primary
21339
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
AN2712
—
SC
Enumeration date
08/07/2017
Last updated
06/10/2024
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