Basic Information
| Provider Information | |||||||||
| NPI: | 1689115727 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | LEE | ||||||||
| FirstName: | MEREDITH | ||||||||
| MiddleName: | ALICIA | ||||||||
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| Credential: | NP-C | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1001 PARKWAY DR | ||||||||
| Address2: | |||||||||
| City: | BURLINGTON | ||||||||
| State: | IA | ||||||||
| PostalCode: | 526013435 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 1223 S GEAR AVE | ||||||||
| Address2: | #304 | ||||||||
| City: | WEST BURLINGTON | ||||||||
| State: | IA | ||||||||
| PostalCode: | 526551682 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3197683200 | ||||||||
| FaxNumber: | 3197683234 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/08/2017 | ||||||||
| LastUpdateDate: | 09/03/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | A146453 | IA | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.