Provider Demographics
NPI:1396273348
Name:FRIEND, LEE ANNE (RN)
Entity type:Individual
Prefix:
First Name:LEE
Middle Name:ANNE
Last Name:FRIEND
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:103 FARM VIEW LN
Mailing Address - Street 2:
Mailing Address - City:FORISTELL
Mailing Address - State:MO
Mailing Address - Zip Code:63348-1075
Mailing Address - Country:US
Mailing Address - Phone:1314-610-8426
Mailing Address - Fax:
Practice Address - Street 1:103 FARM VIEW LN
Practice Address - Street 2:
Practice Address - City:FORISTELL
Practice Address - State:MO
Practice Address - Zip Code:63348-1075
Practice Address - Country:US
Practice Address - Phone:314-610-8426
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-02
Last Update Date:2017-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO200016488163WG0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice