Provider Demographics
NPI:1851572507
Name:LEE, EUNHWA K (NP)
Entity Type:Individual
Prefix:
First Name:EUNHWA
Middle Name:K
Last Name:LEE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1817 PROFESSIONAL DR
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95825-2106
Mailing Address - Country:US
Mailing Address - Phone:916-977-0741
Mailing Address - Fax:916-977-0547
Practice Address - Street 1:1817 PROFESSIONAL DR
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95825-2106
Practice Address - Country:US
Practice Address - Phone:916-977-0741
Practice Address - Fax:916-977-0547
Is Sole Proprietor?:No
Enumeration Date:2007-11-23
Last Update Date:2007-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA343421364SC2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SC2300XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistChronic Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA343421OtherCALIFORNIA RN NUMBER