Provider Demographics
NPI:1083451819
Name:LEE, ALEXA (CRNP)
Entity type:Individual
Prefix:MISS
First Name:ALEXA
Middle Name:
Last Name:LEE
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:419 VIRGINIA AVE
Mailing Address - Street 2:
Mailing Address - City:AMBRIDGE
Mailing Address - State:PA
Mailing Address - Zip Code:15003-1604
Mailing Address - Country:US
Mailing Address - Phone:412-518-2867
Mailing Address - Fax:
Practice Address - Street 1:419 VIRGINIA AVE
Practice Address - Street 2:
Practice Address - City:AMBRIDGE
Practice Address - State:PA
Practice Address - Zip Code:15003-1604
Practice Address - Country:US
Practice Address - Phone:412-518-2867
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-10
Last Update Date:2024-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP022715207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine