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NPI Code Detail

MEDICARE: PAGE SOOKHYUN LEE NP

MEDICARE: PAGE SOOKHYUN LEE NP
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
1363LP2300XPrimary Care Nurse PractitionerAPRN-NP229906GA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1881048973
Entity Type Code : Individual
Provider Name (Legal Business Name) : PAGE SOOKHYUN LEE NP
Provider Business Mailing Address
First Line : PO BOX 1200
Second Line :
City : PLEASANT GROVE
State : UT
Zip : 84062-1200
Country : US
Telephone Number : 800-640-3451
Fax Number :
Provider Business Practice Location Address
First Line : 2480 WINDY HILL RD SE STE 405
Second Line :
City : MARIETTA
State : GA
Zip : 30067-8658
Country : US
Telephone Number : 800-640-3451
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/15/2016
Last Update Date : 01/27/2026

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