MS. MYRNA LEE P.A.-C NPI 1194833111

NPI Information

  • NPI: 1194833111
  • Provider Name: MS. MYRNA LEE, P.A.-C
  • Classification: Physician Assistant - 363AM0700X
  • Specialization: Medical
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 1740 E 17TH ST
    SUITE A
    IDAHO FALLS, ID
    ZIP 83404
  • Phone: (208) 346-7500

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NPI Details

MS. Myrna Lee, P.A.-C is a medical physician assistant in Idaho Falls, ID with 26 years of experience. MS. Myrna Lee, P.A.-C NPI is 1194833111. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

1740 E 17TH ST
SUITE A
IDAHO FALLS, ID
ZIP 83404-375
Phone: (208) 346-7500
Fax: (208) 346-7501

The NPI 1194833111 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 8/29/2006 and was last updated on 5/18/2009.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363AM0700XPhysician AssistantMedicalPA334IDAHOYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1P58408MEDICARE UPINIDAHO
2806327800MEDICAIDIDAHO

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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