MEDICARE: TESS LEE FNP-BC

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	163WC0200X	Critical Care Medicine Registered Nurse	RN200383	MD
2	363LF0000X	Family Nurse Practitioner	RN1027279	DC

General Provider Information

NPI Number	:	1396230926
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TESS LEE FNP-BC

Provider Business Mailing Address
First Line	:	8455 COLESVILLE RD # 1125
Second Line	:
City	:	SILVER SPRING
State	:	MD
Zip	:	20910-3315
Country	:	US
Telephone Number	:	301-615-8228
Fax Number	:

Provider Business Practice Location Address
First Line	:	8455 COLESVILLE RD # 1125
Second Line	:
City	:	SILVER SPRING
State	:	MD
Zip	:	20910-3315
Country	:	US
Telephone Number	:	301-615-8228
Fax Number	:

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

Provider Enumeration Date	:	06/26/2018
Last Update Date	:	12/17/2020

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