MEDICARE: MRS. JAIME LEE CRNP

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	363LA2100X	Acute Care Nurse Practitioner	RN964859	DC
2	363LA2100X	Acute Care Nurse Practitioner	APRN9358561	FL

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	:	1871578526
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. JAIME LEE CRNP

Provider Business Mailing Address
First Line	:	2023 37TH ST NW
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20007-2207
Country	:	US
Telephone Number	:	301-529-1217
Fax Number	:

Provider Business Practice Location Address
First Line	:	1801 S OSPREY AVE UNIT 101
Second Line	:
City	:	SARASOTA
State	:	FL
Zip	:	34239-3608
Country	:	US
Telephone Number	:	202-444-5478
Fax Number	:

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

Provider Enumeration Date	:	12/14/2005
Last Update Date	:	02/29/2024

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