Provider Demographics
NPI:1336856665
Name:LEE, JENNIFER ANN
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:ANN
Last Name:LEE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:330 E FELL ST
Mailing Address - Street 2:
Mailing Address - City:SUMMIT HILL
Mailing Address - State:PA
Mailing Address - Zip Code:18250-1308
Mailing Address - Country:US
Mailing Address - Phone:347-922-8571
Mailing Address - Fax:
Practice Address - Street 1:330 E FELL ST
Practice Address - Street 2:
Practice Address - City:SUMMIT HILL
Practice Address - State:PA
Practice Address - Zip Code:18250-1308
Practice Address - Country:US
Practice Address - Phone:347-922-8571
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-07
Last Update Date:2022-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula