MEDICARE: JENNIFER E. LEE CNP

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	APRN.CNP..0028307	OH

General Provider Information

NPI Number	:	1285454629
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNIFER E. LEE CNP

Provider Business Mailing Address
First Line	:	PO BOX 7527
Second Line	:
City	:	DUBLIN
State	:	OH
Zip	:	43017-0727
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	7340 E BROAD ST
Second Line	:	SUITE B
City	:	COLUMBUS
State	:	OH
Zip	:	43004
Country	:	US
Telephone Number	:	614-566-7300
Fax Number	:	614-533-0293

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

Provider Enumeration Date	:	10/11/2024
Last Update Date	:	12/02/2024

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