Renee Lee, FNP
Individual provider Active NPI Physician Assistant · Cavalier, ND
NPI 1104962299 · NPPES record last updated Jul 9, 2007
Key facts
- NPI
- 1104962299
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- PAC0055 (ND)
- Practice address
- 301 Mountain St E
Cavalier, ND 58220-4015 - Phone
- (701) 265-6307
- NPI assigned
- Jan 29, 2007
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PAC0055 | ND | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pembina County Memorial Hospital Association | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PAC0055 | ND | Yes |
Addresses
Primary practice location
301 Mountain St E
Cavalier, ND 58220-4015
Mailing address
PO Box 380
Cavalier, ND 58220-0380
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| MEDICAID ID | Medicaid | ND |
Other providers in Cavalier, ND
- Taresa Loann Jones
- Inder V Khokha
- Emily Koenig
- Sean Allan La Frentz
- Diana Laxdal
- Angela Marie Longtin
- Terri A Machart
- Kinsey Oakland Maertens
- Yanelli Martinez
- Jenna Marie Mertz
All providers in Cavalier, ND · Physician Assistant in North Dakota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 9, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.