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NPI Code Detail

MEDICARE: BIYYIAH LEE BSN

MEDICARE: BIYYIAH LEE BSN
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
1163W00000XRegistered Nurse4704311637MI

General Provider Information

NPI Number : 1740675321
Entity Type Code : Individual
Provider Name (Legal Business Name) : BIYYIAH LEE BSN
Provider Business Mailing Address
First Line : 3104 WOODLAND HILLS DR
Second Line : APT 31
City : ANN ARBOR
State : MI
Zip : 48108-2138
Country : US
Telephone Number : 773-844-8724
Fax Number :
Provider Business Practice Location Address
First Line : 3104 WOODLAND HILLS DR
Second Line : APT 31
City : ANN ARBOR
State : MI
Zip : 48108-2138
Country : US
Telephone Number : 773-844-8724
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/01/2015
Last Update Date : 04/01/2015

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