MEDICARE: DR. BONNIE JEAN LEES MD

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	2080N0001X	Neonatal-Perinatal Medicine Physician	14359	OR
2	2080N0001X	Neonatal-Perinatal Medicine Physician	38163	CA
3	2080N0001X	Neonatal-Perinatal Medicine Physician	4680	NV
4	2080N0001X	Neonatal-Perinatal Medicine Physician	9568	ND
5	2080N0001X	Neonatal-Perinatal Medicine Physician	30574	KS
6	2080N0001X	Neonatal-Perinatal Medicine Physician	47431	MN
7	2080N0001X	Neonatal-Perinatal Medicine Physician	2005021462	MO
8	2080N0001X	Neonatal-Perinatal Medicine Physician	0430574	KS
9	208000000X	Pediatrics Physician	0430574	KS
10	2080N0001X	Neonatal-Perinatal Medicine Physician	25692	NE
11	2080N0001X	Neonatal-Perinatal Medicine Physician	31185	ZZ
12	2080N0001X	Neonatal-Perinatal Medicine Physician	23313	CT
13	2080N0001X	Neonatal-Perinatal Medicine Physician	12091	MT

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1518959295
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BONNIE JEAN LEES MD

Provider Business Mailing Address
First Line	:	8200 DODGE STREET
Second Line	:
City	:	OMAHA
State	:	NE
Zip	:	68114-4113
Country	:	US
Telephone Number	:	402-955-6140
Fax Number	:	402-955-3398

Provider Business Practice Location Address
First Line	:	8200 DODGE STREET
Second Line	:	CHILDREN'S HOSPITAL & MEDICARE CENTER
City	:	OMAHA
State	:	NE
Zip	:	68114-4113
Country	:	US
Telephone Number	:	402-955-6140
Fax Number	:	402-955-3398

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

Provider Enumeration Date	:	08/18/2005
Last Update Date	:	07/09/2010

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Directions to “ DR. BONNIE JEAN LEES MD” Practice Location

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