Provider Demographics
NPI:1932415064
Name:LEE, EMILY CLAIRE (FNP)
Entity type:Individual
Prefix:MS
First Name:EMILY
Middle Name:CLAIRE
Last Name:LEE
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1705 E 11TH ST
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78702-2709
Mailing Address - Country:US
Mailing Address - Phone:512-978-8400
Mailing Address - Fax:512-901-9785
Practice Address - Street 1:1705 E 11TH ST
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78702-2709
Practice Address - Country:US
Practice Address - Phone:512-978-8400
Practice Address - Fax:512-901-9785
Is Sole Proprietor?:No
Enumeration Date:2010-08-26
Last Update Date:2017-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP119185363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1275726853OtherNPI FOR CSCHC
TX1821185299OtherAGENCY NPI
TX154467801Medicaid
1275620551OtherROBERTSON CLINIC NPI
TX451986Medicare Oscar/Certification
TX154467803Medicaid
TX187842301Medicaid
TX671861Medicare Oscar/Certification
TX451942Medicare Oscar/Certification