Provider Demographics
NPI:1063897726
Name:LEE, LAURIN GAYMON (FNP-BC)
Entity type:Individual
Prefix:MRS
First Name:LAURIN
Middle Name:GAYMON
Last Name:LEE
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:244 CHURCH ST
Mailing Address - Street 2:
Mailing Address - City:SUMTER
Mailing Address - State:SC
Mailing Address - Zip Code:29150-4256
Mailing Address - Country:US
Mailing Address - Phone:803-775-1001
Mailing Address - Fax:803-774-1012
Practice Address - Street 1:244 CHURCH ST
Practice Address - Street 2:
Practice Address - City:SUMTER
Practice Address - State:SC
Practice Address - Zip Code:29150-4256
Practice Address - Country:US
Practice Address - Phone:803-775-1001
Practice Address - Fax:803-774-1012
Is Sole Proprietor?:No
Enumeration Date:2015-07-23
Last Update Date:2015-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC19623363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily