Kenneth Joe Lee
Individual provider Active NPI Registered Nurse · Tremonton, UT
NPI 1295488484 · NPPES record last updated Jan 28, 2022
Key facts
- NPI
- 1295488484
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Registered Nurse 163W00000X
- License
- 43661 (OR)
- Practice address
- 9825 N 10800 W
Tremonton, UT 84337-9222 - Phone
- (888) 851-3677
- NPI assigned
- Jan 28, 2022
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 43661 | OR | MD | Registered Nurse |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 43661 | OR | Yes |
Addresses
Primary practice location
9825 N 10800 W
Tremonton, UT 84337-9222
Mailing address
9825 N 10800 W
Tremonton, UT 84337-9222
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | UT |
Other providers in Tremonton, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 28, 2022. 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.