MEDICARE: JAZZMIN BRIANA LEE

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	363LF0000X	Family Nurse Practitioner	R239774	MD
2	163W00000X	Registered Nurse	R239774	MD

General Provider Information

NPI Number	:	1245190024
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAZZMIN BRIANA LEE

Provider Business Mailing Address
First Line	:	6430 ROCKLEDGE DR STE 100
Second Line	:
City	:	BETHESDA
State	:	MD
Zip	:	20817-1847
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6430 ROCKLEDGE DR STE 100
Second Line	:
City	:	BETHESDA
State	:	MD
Zip	:	20817-1847
Country	:	US
Telephone Number	:	301-493-4334
Fax Number	:

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

Provider Enumeration Date	:	11/14/2025
Last Update Date	:	05/29/2026

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Directions to “ JAZZMIN BRIANA LEE ” Practice Location

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