Basic Information
| Provider Information | |||||||||
| NPI: | 1801180948 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | LEE | ||||||||
| FirstName: | TONYA | ||||||||
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| Credential: | RN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2086 WASHINGTON DR | ||||||||
| Address2: | |||||||||
| City: | RICHMOND HEIGHTS | ||||||||
| State: | OH | ||||||||
| PostalCode: | 441431357 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2164697926 | ||||||||
| FaxNumber: | 2162685146 | ||||||||
| Practice Location | |||||||||
| Address1: | 30575 BAINBRIDGE RD | ||||||||
| Address2: | |||||||||
| City: | SOLON | ||||||||
| State: | OH | ||||||||
| PostalCode: | 441392221 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4405425000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/07/2011 | ||||||||
| LastUpdateDate: | 03/17/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163W00000X | 310598 | OH | N | Nursing Service Providers | Registered Nurse | 363L00000X | APRN.CNP.020462 | OH | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner |
No ID Information.