Provider Demographics
NPI:1306567250
Name:LEE, JAMESHIA S
Entity type:Individual
Prefix:
First Name:JAMESHIA
Middle Name:S
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 1:700 FOREST GLEN DR APT 67
Mailing Address - Street 2:
Mailing Address - City:PALATKA
Mailing Address - State:FL
Mailing Address - Zip Code:32177-8903
Mailing Address - Country:US
Mailing Address - Phone:904-315-8091
Mailing Address - Fax:904-830-5606
Practice Address - Street 1:700 FOREST GLEN DR APT 67
Practice Address - Street 2:
Practice Address - City:PALATKA
Practice Address - State:FL
Practice Address - Zip Code:32177-8903
Practice Address - Country:US
Practice Address - Phone:904-315-8091
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-08
Last Update Date:2024-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL376J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker