MEDICARE: MRS. JULIE ERICA LEE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	364SF0001X	Family Health Clinical Nurse Specialist	34718	TN
2	163WC1500X	Community Health Registered Nurse	0000115712	TN
3	363LF0000X	Family Nurse Practitioner	34718	TN

General Provider Information

NPI Number	:	1083729305
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. JULIE ERICA LEE

Provider Business Mailing Address
First Line	:	1793 N CROSSBERRY CV
Second Line	:
City	:	COLLIERVILLE
State	:	TN
Zip	:	38017-2446
Country	:	US
Telephone Number	:	913-680-9502
Fax Number	:

Provider Business Practice Location Address
First Line	:	1793 N CROSSBERRY CV
Second Line	:
City	:	COLLIERVILLE
State	:	TN
Zip	:	38017-2446
Country	:	US
Telephone Number	:	913-680-9502
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/19/2006
Last Update Date	:	05/20/2026

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