Healthcare Provider Details

I. General information

NPI: 1962209064
Provider Name (Legal Business Name): JEE Y LEE FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/26/2025
Last Update Date: 05/22/2026
Certification Date: 05/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3905 BROOKSIDE PKWY STE 300
ALPHARETTA GA
30022-4458
US

IV. Provider business mailing address

PO BOX 117598
ATLANTA GA
30368-7598
US

V. Phone/Fax

Practice location:
  • Phone: 770-442-1911
  • Fax: 770-442-0306
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN324450
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: