Provider Demographics
NPI:1104472679
Name:DIONNE, LEE KNIGHT (PA-C)
Entity type:Individual
Prefix:
First Name:LEE
Middle Name:KNIGHT
Last Name:DIONNE
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:LEE
Other - Middle Name:KNIGHT
Other - Last Name:MALONEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5310 HARVEST HILL RD STE 290
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75230-5826
Mailing Address - Country:US
Mailing Address - Phone:214-420-0650
Mailing Address - Fax:
Practice Address - Street 1:1420 W CANAL CT STE 50
Practice Address - Street 2:
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80120-5656
Practice Address - Country:US
Practice Address - Phone:303-795-2030
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-12
Last Update Date:2024-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPA.0005905363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant