Provider Demographics
NPI:1124244397
Name:LEE, DOROTHY J (RN)
Entity type:Individual
Prefix:
First Name:DOROTHY
Middle Name:J
Last Name:LEE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7124 WILLOW AVE
Mailing Address - Street 2:
Mailing Address - City:TAKOMA PARK
Mailing Address - State:MD
Mailing Address - Zip Code:20912-4404
Mailing Address - Country:US
Mailing Address - Phone:240-601-3319
Mailing Address - Fax:
Practice Address - Street 1:801 17TH ST NE
Practice Address - Street 2:801 17TH STREET, NE
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20002-7200
Practice Address - Country:US
Practice Address - Phone:202-398-5520
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-17
Last Update Date:2013-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCRN63900367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife