Provider Demographics
NPI:1275312571
Name:LEE, JENNIFER (APRN, FNP-C)
Entity type:Individual
Prefix:MS
First Name:JENNIFER
Middle Name:
Last Name:LEE
Suffix:
Gender:F
Credentials:APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5610 GREENWICH DR
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76018-2321
Mailing Address - Country:US
Mailing Address - Phone:682-230-0662
Mailing Address - Fax:
Practice Address - Street 1:8220 WALNUT HILL LN STE 600
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75231-4433
Practice Address - Country:US
Practice Address - Phone:214-238-3074
Practice Address - Fax:214-238-3608
Is Sole Proprietor?:No
Enumeration Date:2023-09-26
Last Update Date:2024-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1137444363LW0102X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health