MEDICARE: HEATHER JEAN 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	363LA2200X	Adult Health Nurse Practitioner	11927	OH

General Provider Information

NPI Number	:	1447550199
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HEATHER JEAN LEE CNP

Provider Business Mailing Address
First Line	:	2563 SNOUFFER PL
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43235-2865
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2563 SNOUFFER PL
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43235-2865
Country	:	US
Telephone Number	:	614-506-2119
Fax Number	:

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

Provider Enumeration Date	:	10/28/2010
Last Update Date	:	10/28/2010

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