Provider Demographics
NPI:1104888320
Name:LEE, JOYCE ELAINE (PA C)
Entity type:Individual
Prefix:MS
First Name:JOYCE
Middle Name:ELAINE
Last Name:LEE
Suffix:
Gender:F
Credentials:PA C
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:2 SOUTH CASCADE AVENUE
Mailing Address - Street 2:SUITE 140
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80603-1604
Mailing Address - Country:US
Mailing Address - Phone:719-538-2900
Mailing Address - Fax:719-538-2961
Practice Address - Street 1:1633 MEDICAL CENTER POINT
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80907
Practice Address - Country:US
Practice Address - Phone:719-636-2999
Practice Address - Fax:719-667-4108
Is Sole Proprietor?:No
Enumeration Date:2006-04-04
Last Update Date:2016-11-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MT425363A00000X
CO56363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO40853381Medicaid
COC809976Medicare PIN
CO40853381Medicaid