Provider Demographics
NPI:1447477351
Name:LEE, ESTHER TAE
Entity type:Individual
Prefix:
First Name:ESTHER
Middle Name:TAE
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 1:9114 SAINT ANDREWS PL
Mailing Address - Street 2:
Mailing Address - City:COLLEGE PARK
Mailing Address - State:MD
Mailing Address - Zip Code:20740-4026
Mailing Address - Country:US
Mailing Address - Phone:301-935-4825
Mailing Address - Fax:
Practice Address - Street 1:UNIVERSITY OF MARYLAND HEALTH CTR
Practice Address - Street 2:140 CAMPUS DRIVE
Practice Address - City:COLLEGE PARK
Practice Address - State:MD
Practice Address - Zip Code:20742-0001
Practice Address - Country:US
Practice Address - Phone:301-314-8157
Practice Address - Fax:301-314-8590
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR075161163WC1400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1400XNursing Service ProvidersRegistered NurseCollege Health