Provider Demographics
NPI:1396230926
Name:LEE, TESS (FNP-BC)
Entity Type:Individual
Prefix:
First Name:TESS
Middle Name:
Last Name:LEE
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8455 COLESVILLE RD # 1125
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20910-3315
Mailing Address - Country:US
Mailing Address - Phone:301-615-8228
Mailing Address - Fax:
Practice Address - Street 1:8455 COLESVILLE RD # 1125
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20910-3315
Practice Address - Country:US
Practice Address - Phone:301-615-8228
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-26
Last Update Date:2020-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDRN200383163WC0200X
DCRN1027279363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine