Provider Demographics
NPI:1265788608
Name:LEE, JEANMARIE (CNA)
Entity type:Individual
Prefix:MRS
First Name:JEANMARIE
Middle Name:
Last Name:LEE
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 638
Mailing Address - Street 2:
Mailing Address - City:EASTHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02642-0638
Mailing Address - Country:US
Mailing Address - Phone:508-237-2425
Mailing Address - Fax:
Practice Address - Street 1:10 LOMBARD LN
Practice Address - Street 2:
Practice Address - City:EASTHAM
Practice Address - State:MA
Practice Address - Zip Code:02642
Practice Address - Country:US
Practice Address - Phone:508-255-7405
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-02
Last Update Date:2012-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide