Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207KA0200X | Allergist | 0101242747 | VA |
NPI | 1346423381 |
---|---|
Provider Name | Dr. Vickie Kyuran Lee |
First Address | Ashburn, VA 20147-5076 |
Second Address | Ashburn, VA 20147-5076 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/12/2007 |
Last Update Date | 25/08/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1346423381 | (05) | VA |
3179242 | ONENET (01) | VA |
4569213 | CIGNA (01) | VA |
952108 | AETNA (01) | VA |
D393-0001 | CAREFIRST BCBS (01) | VA |