MEDICARE: MRS. ESTHER JIHYE LEE FNP-C

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	163W00000X	Registered Nurse	0001262091	VA
2	363LF0000X	Family Nurse Practitioner	0024190077	VA

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

General Provider Information

NPI Number	:	1588400063
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ESTHER JIHYE LEE FNP-C

Provider Business Mailing Address
First Line	:	21001 SYCOLIN RD STE 180
Second Line	:
City	:	ASHBURN
State	:	VA
Zip	:	20147-4074
Country	:	US
Telephone Number	:	703-687-4363
Fax Number	:	703-723-7470

Provider Business Practice Location Address
First Line	:	21001 SYCOLIN RD STE 180
Second Line	:
City	:	ASHBURN
State	:	VA
Zip	:	20147-4074
Country	:	US
Telephone Number	:	703-687-4363
Fax Number	:	703-723-7470

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

Provider Enumeration Date	:	07/03/2024
Last Update Date	:	10/29/2024

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