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NPI Code Detail

MEDICARE: YEJIN LEE

MEDICARE: YEJIN 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
1363LF0000XFamily Nurse PractitionerRN315030GA

General Provider Information

NPI Number : 1841053568
Entity Type Code : Individual
Provider Name (Legal Business Name) : YEJIN LEE
Provider Business Mailing Address
First Line : 1593 LINE CIR APT 4
Second Line :
City : DECATUR
State : GA
Zip : 30032-3355
Country : US
Telephone Number : 678-827-1412
Fax Number :
Provider Business Practice Location Address
First Line : 1834 CLAIRMONT RD STE 100
Second Line :
City : DECATUR
State : GA
Zip : 30033-3405
Country : US
Telephone Number : 167-882-7141
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/05/2024
Last Update Date : 02/05/2024

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Directions to “ YEJIN LEE ” Practice Location

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