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Individual

MRS. KNICOLE A LEE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DNP,FNP-BC

Contact information

Practice address
224 PEACHTREE ST, BAXLEY, GA 31513-8079
(912) 705-5483
(912) 705-5484
Mailing address
224 PEACHTREE ST, BAXLEY, GA 31513-8079
(912) 705-5483
(912) 705-5484

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
RN116307
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
332370125G
GA
Enumeration date
10/15/2007
Last updated
09/16/2024
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