Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LC1500X | Nurse Practitioner - Community Health | F320006 | NY |
Y | 363LP0808X | Nurse Practitioner - Psychiatric/Mental Health | F401018 | NY |
NPI | 1912948753 |
---|---|
Provider Name | Jeanette J Lee |
First Address | Endicott, NY 13760-3851 |
Second Address | Binghamton, NY 13901-2756 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/06/2006 |
Last Update Date | 14/07/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0320F320006 | (05) | NY |