MEDICARE: DOROTHY J LEE RN

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	367A00000X	Advanced Practice Midwife	RN63900	DC

General Provider Information

NPI Number	:	1124244397
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DOROTHY J LEE RN

Provider Business Mailing Address
First Line	:	7124 WILLOW AVE
Second Line	:
City	:	TAKOMA PARK
State	:	MD
Zip	:	20912-4404
Country	:	US
Telephone Number	:	240-601-3319
Fax Number	:

Provider Business Practice Location Address
First Line	:	801 17TH ST NE
Second Line	:	801 17TH STREET, NE
City	:	WASHINGTON
State	:	DC
Zip	:	20002-7200
Country	:	US
Telephone Number	:	202-398-5520
Fax Number	:

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

Provider Enumeration Date	:	04/17/2007
Last Update Date	:	12/03/2013

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