MEDICARE: MISS JENNA WINTER 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	802299	NY

General Provider Information

NPI Number	:	1518829027
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS JENNA WINTER LEE

Provider Business Mailing Address
First Line	:	1078 FULTON ST APT 3C
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11238-2682
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1078 FULTON ST APT 3C
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11238-2682
Country	:	US
Telephone Number	:	512-658-8009
Fax Number	:

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

Provider Enumeration Date	:	12/02/2025
Last Update Date	:	12/02/2025

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Directions to “ MISS JENNA WINTER LEE ” Practice Location

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