Provider Demographics
NPI:1578025060
Name:LEE, ANDREA JULIAN (PCD(DONA))
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:JULIAN
Last Name:LEE
Suffix:
Gender:F
Credentials:PCD(DONA)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 S BROAD ST UNIT 22571
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19110-1048
Mailing Address - Country:US
Mailing Address - Phone:267-670-1857
Mailing Address - Fax:
Practice Address - Street 1:116 S 7TH ST APT 602
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19106-3251
Practice Address - Country:US
Practice Address - Phone:407-310-3557
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-03
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula