Individual
SONG LEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
2357 108TH LN NE, BLAINE, MN 55449-5222
(866) 389-2727
Mailing address
2357 108TH LN NE, BLAINE, MN 55449-5222
(866) 389-2727
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
2015029823
MO
363LF0000X
Family Nurse Practitioner
21056
TN
363LF0000X
Family Nurse Practitioner
Primary
8018
MN
Other
Enumeration date
08/20/2015
Last updated
03/09/2021
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