Provider Demographics
NPI:1437756681
Name:LEE, JOANNE JIYOON (MSN, FNP-BC)
Entity Type:Individual
Prefix:
First Name:JOANNE
Middle Name:JIYOON
Last Name:LEE
Suffix:
Gender:F
Credentials:MSN, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2675 N DECATUR RD STE 301
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:GA
Mailing Address - Zip Code:30033-6132
Mailing Address - Country:US
Mailing Address - Phone:404-294-0472
Mailing Address - Fax:404-294-1558
Practice Address - Street 1:2675 N DECATUR RD STE 301
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30033-6132
Practice Address - Country:US
Practice Address - Phone:404-294-0472
Practice Address - Fax:404-294-1558
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-01
Last Update Date:2020-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN282306363LF0000X, 363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's HealthGroup - Multi-Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty