Provider Demographics
NPI:1700167681
Name:LEE, ANDREA DANIELLE (NP)
Entity type:Individual
Prefix:MS
First Name:ANDREA
Middle Name:DANIELLE
Last Name:LEE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1324 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37064-3784
Mailing Address - Country:US
Mailing Address - Phone:615-794-1542
Mailing Address - Fax:
Practice Address - Street 1:4546 EL CAMINO REAL STE B7
Practice Address - Street 2:
Practice Address - City:LOS ALTOS
Practice Address - State:CA
Practice Address - Zip Code:94022-1069
Practice Address - Country:US
Practice Address - Phone:866-362-4246
Practice Address - Fax:650-260-6030
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-06
Last Update Date:2025-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95036065363LP0808X
TNRN0000182403163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty
No163W00000XNursing Service ProvidersRegistered Nurse