Provider Demographics
NPI:1306683594
Name:LEE, CHERYL LEEANN
Entity type:Individual
Prefix:
First Name:CHERYL
Middle Name:LEEANN
Last Name:LEE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:606 N WEENONAH AVE
Mailing Address - Street 2:
Mailing Address - City:CLAREMORE
Mailing Address - State:OK
Mailing Address - Zip Code:74017-6034
Mailing Address - Country:US
Mailing Address - Phone:918-927-2201
Mailing Address - Fax:
Practice Address - Street 1:606 N WEENONAH AVE
Practice Address - Street 2:
Practice Address - City:CLAREMORE
Practice Address - State:OK
Practice Address - Zip Code:74017-6034
Practice Address - Country:US
Practice Address - Phone:918-927-2201
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-13
Last Update Date:2024-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist