Jacqueline Lee
Licensed Practical Nurse in Stonecrest, GA. Individual provider (NPI-1).
NPI number1154098366
StatusActive
Last updated in NPPESAug 25, 2021
Details
- NPI
- 1154098366
- Entity type
- Individual (NPI-1)
- Name
- Jacqueline Lee
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Aug 25, 2021
- Certification date
- Aug 25, 2021
- Last updated
- Aug 25, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 164W00000X | Licensed Practical Nurse | LPN095403 | GA | Yes |
Practice location
6310 Browns Mill RdStonecrest, GA 30038-4209
Phone 321-557-6041
Mailing address
6310 Browns Mill RdStonecrest, GA 30038-4209
Phone 321-557-6041
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