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General NPI Number Information
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NPI Number | 1063201820
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Entity Type | Individual
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Provider Name | JULIE K LEE RDN, LDN, CDCES,MLDE
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Gender | Female
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Dates
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Enumeration Date | 05/06/2025
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Last Update Date | 05/06/2025
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Provider Practice Location Address
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Address Line | 740 E 10TH AVE
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City | BOWLING GREEN
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State | KY
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Zip | 42101-2318
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Country | US
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Telephone | 270-745-1010
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Fax |
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Provider Business Mailing Address
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Address Line | 250 PARK ST
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City | BOWLING GREEN
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State | KY
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Zip | 42101-1760
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Country | US
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Telephone | 270-745-1458
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 133VN1006X
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Taxonomy Name | Metabolic Nutrition Registered Dietitian
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License Number | 126021
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License Number State | KY
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Taxonomy #2
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Taxonomy Code | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number | 126021
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License Number State | KY
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