MEDICARE: JANET LYNN 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	163W00000X	Registered Nurse	4704261446	MI
2	163W00000X	Registered Nurse	337150	OH

General Provider Information

NPI Number	:	1356524102
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JANET LYNN LEE RN

Provider Business Mailing Address
First Line	:	11345 DOUGLAS RD
Second Line	:
City	:	TEMPERANCE
State	:	MI
Zip	:	48182-9770
Country	:	US
Telephone Number	:	734-854-1889
Fax Number	:

Provider Business Practice Location Address
First Line	:	2151 E ERIE RD
Second Line	:
City	:	ERIE
State	:	MI
Zip	:	48133-9320
Country	:	US
Telephone Number	:	734-317-7025
Fax Number	:

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

Provider Enumeration Date	:	12/14/2007
Last Update Date	:	02/13/2008

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