Provider Demographics
NPI:1871578526
Name:LEE, JAIME (CRNP)
Entity type:Individual
Prefix:MRS
First Name:JAIME
Middle Name:
Last Name:LEE
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2023 37TH ST NW
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20007-2207
Mailing Address - Country:US
Mailing Address - Phone:301-529-1217
Mailing Address - Fax:
Practice Address - Street 1:1801 S OSPREY AVE UNIT 101
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34239-3608
Practice Address - Country:US
Practice Address - Phone:202-444-5478
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-12-14
Last Update Date:2024-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCRN964859363LA2100X
FLAPRN9358561363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
Q45742Medicare UPIN
DC017099M65Medicare PIN