Provider Demographics
NPI:1366221079
Name:LEE, SUSAN BOND (RN)
Entity type:Individual
Prefix:
First Name:SUSAN
Middle Name:BOND
Last Name:LEE
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 1:1070 S LAKE DR
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:SC
Mailing Address - Zip Code:29072-3703
Mailing Address - Country:US
Mailing Address - Phone:803-312-5284
Mailing Address - Fax:
Practice Address - Street 1:1070 S LAKE DR
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:SC
Practice Address - Zip Code:29072-3703
Practice Address - Country:US
Practice Address - Phone:803-312-5284
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-22
Last Update Date:2023-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9549531163WN0003X, 163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health
No163WN0003XNursing Service ProvidersRegistered NurseNeonatal, Low-Risk