Provider Demographics
NPI:1568286631
Name:LEE, LISA ANNE (ELECTROLOGIST)
Entity type:Individual
Prefix:MRS
First Name:LISA
Middle Name:ANNE
Last Name:LEE
Suffix:
Gender:F
Credentials:ELECTROLOGIST
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:3815 W SAINT JOSEPH ST STE A350
Mailing Address - Street 2:
Mailing Address - City:LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48917-5607
Mailing Address - Country:US
Mailing Address - Phone:517-643-3244
Mailing Address - Fax:
Practice Address - Street 1:3815 W SAINT JOSEPH ST STE A350
Practice Address - Street 2:
Practice Address - City:LANSING
Practice Address - State:MI
Practice Address - Zip Code:48917-5607
Practice Address - Country:US
Practice Address - Phone:517-643-3244
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-14
Last Update Date:2024-11-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI2766007124207NS0135X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207NS0135XAllopathic & Osteopathic PhysiciansDermatologyProcedural Dermatology