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MELISSA MORTON LEE FNP
Family >> Nurse Practitioner >> Physician Assistants & Advanced Practice Nursing ProvidersRegistrant NPI Number: 1265812408
Individual Registrant: MELISSA MORTON LEE FNP
Gender: F
Not Sole Proprietor
Gender: F
Not Sole Proprietor
Location and contact information for practice:
87 S BURNT MILL RD LA FAYETTE, GA 30728-4263 US
Tel: 706-996-2797 Fax: 706-657-2958
Tel: 706-996-2797 Fax: 706-657-2958
Contact information for business:
13570 N MAIN ST TRENTON, GA 30752-2012 US
Tel: 706-956-2665 Fax: 706-657-2958
Tel: 706-956-2665 Fax: 706-657-2958
Registration Information:
NPI: 1265812408
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 363LF0000X | Physician Assistants & Advanced Practice Nursing Providers Nurse Practitioner Family | GA | RN209627 |
| N | 363LF0000X | Physician Assistants & Advanced Practice Nursing Providers Nurse Practitioner | TN | 178822 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
| 000211956A | GA | 05 |
