Provider Demographics
NPI:1215431044
Name:LEE, JOSHUA EDWARD (LPN)
Entity type:Individual
Prefix:
First Name:JOSHUA
Middle Name:EDWARD
Last Name:LEE
Suffix:
Gender:M
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 152
Mailing Address - Street 2:
Mailing Address - City:JUNCTION CITY
Mailing Address - State:OH
Mailing Address - Zip Code:43748-0152
Mailing Address - Country:US
Mailing Address - Phone:740-605-7143
Mailing Address - Fax:
Practice Address - Street 1:203 N MAIN ST
Practice Address - Street 2:
Practice Address - City:NEW LEXINGTON
Practice Address - State:OH
Practice Address - Zip Code:43764-1264
Practice Address - Country:US
Practice Address - Phone:740-342-1991
Practice Address - Fax:740-342-1429
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-19
Last Update Date:2018-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH160645164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse