Rebecca Lee, CPNP-PC

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

APRN11029330 Issued in FL

Practice address

4196 W US Highway 90 Ste 105
Lake City, FL 32055-8834

Phone

(386) 243-8474

Fax

(386) 438-5945

NPI assigned

Sep 13, 2021

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Grace Pediatrics PL

  • Rural Health Clinic/Center
  • Fort White, FL
  • NPI 1326885294
  NPD
• Grace Pediatrics PL

  • Pediatric Nurse Practitioner
  • Lake City, FL
  • NPI 1720362429

  Pediatrics

  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1631491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712275200000",
    "number": "1376213215",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4196 W US HIGHWAY 90 STE 105",
            "city": "LAKE CITY",
            "state": "FL",
            "postal_code": "320558834",
            "telephone_number": "386-243-8474",
            "fax_number": "386-438-5945"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4196 W US HIGHWAY 90 STE 105",
            "city": "LAKE CITY",
            "state": "FL",
            "postal_code": "320558834",
            "telephone_number": "386-243-8474",
            "fax_number": "386-438-5945"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "REBECCA",
        "credential": "CPNP-PC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-09-13",
        "last_updated": "2024-04-05",
        "certification_date": "2024-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Pediatrics",
            "state": "FL",
            "license": "RN9410116",
            "primary": false
        },
        {
            "code": "163WP0218X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Pediatric Oncology",
            "state": "FL",
            "license": "RN9410116",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "FL",
            "license": "APRN11029330",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "FL",
            "license": "RN9410116",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kadijh Lee
• Keverly Michele Lee
• Lawrence A Lee
• Marcia Lee
• Mary Regina Lee, LPN
• Takita Lyshawn Lee
• Tamica Deandra Lee
• Tien-Min Lee, MD
• Valerie Herbst Lee
• Tammie Lefebvre

• Pediatric Nurse Practitioner in Lake City, FL
• Providers in Lake City, FL by specialty
• Pediatric Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.