Provider Demographics
NPI:1881048973
Name:LEE, SOOK HYUN (NP)
Entity type:Individual
Prefix:
First Name:SOOK HYUN
Middle Name:
Last Name:LEE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:475 PHILIP BLVD
Mailing Address - Street 2:STE 100
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30046
Mailing Address - Country:US
Mailing Address - Phone:770-995-3300
Mailing Address - Fax:770-995-3307
Practice Address - Street 1:2650 LAWRENCEVILLE SUWANEE RD
Practice Address - Street 2:
Practice Address - City:SUWANEE
Practice Address - State:GA
Practice Address - Zip Code:30024-4918
Practice Address - Country:US
Practice Address - Phone:678-205-5000
Practice Address - Fax:678-240-2080
Is Sole Proprietor?:No
Enumeration Date:2016-04-15
Last Update Date:2022-05-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GARN229906363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA003194549Medicaid