MEDICARE: KATHY YOUNG 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	163W00000X	Registered Nurse	2528782	MN

General Provider Information

NPI Number	:	1497614614
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATHY YOUNG LEE

Provider Business Mailing Address
First Line	:	1220 BROOK AVE SE UNIT 111
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55414-7541
Country	:	US
Telephone Number	:	951-807-5298
Fax Number	:

Provider Business Practice Location Address
First Line	:	1220 BROOK AVE SE UNIT 111
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55414-7541
Country	:	US
Telephone Number	:	951-807-5298
Fax Number	:

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

Provider Enumeration Date	:	01/22/2026
Last Update Date	:	01/22/2026

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Directions to “ KATHY YOUNG LEE ” Practice Location

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