Provider Demographics
NPI:1396957700
Name:LEE, ADONICA NINA (RN,MS,IBCLC,CCE,CIMI)
Entity type:Individual
Prefix:MS
First Name:ADONICA
Middle Name:NINA
Last Name:LEE
Suffix:
Gender:F
Credentials:RN,MS,IBCLC,CCE,CIMI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:230 CHURCH RD
Mailing Address - Street 2:
Mailing Address - City:ELKINS PARK
Mailing Address - State:PA
Mailing Address - Zip Code:19027-2728
Mailing Address - Country:US
Mailing Address - Phone:215-635-6477
Mailing Address - Fax:
Practice Address - Street 1:230 CHURCH RD
Practice Address - Street 2:
Practice Address - City:ELKINS PARK
Practice Address - State:PA
Practice Address - Zip Code:19027-2728
Practice Address - Country:US
Practice Address - Phone:215-635-6477
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN264949L163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant