Provider Demographics
NPI:1841039690
Name:LEE, KIMONE VERNE
Entity type:Individual
Prefix:
First Name:KIMONE
Middle Name:VERNE
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 1:3330 LERWICK RD APT 4
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95821-1934
Mailing Address - Country:US
Mailing Address - Phone:916-583-0185
Mailing Address - Fax:
Practice Address - Street 1:3330 LERWICK RD APT 4
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95821-1934
Practice Address - Country:US
Practice Address - Phone:916-583-0185
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-22
Last Update Date:2024-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula