Provider Demographics
NPI:1588400063
Name:LEE, ESTHER JIHYE (FNP-C)
Entity type:Individual
Prefix:MRS
First Name:ESTHER
Middle Name:JIHYE
Last Name:LEE
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21001 SYCOLIN RD STE 180
Mailing Address - Street 2:
Mailing Address - City:ASHBURN
Mailing Address - State:VA
Mailing Address - Zip Code:20147-4074
Mailing Address - Country:US
Mailing Address - Phone:703-687-4363
Mailing Address - Fax:703-723-7470
Practice Address - Street 1:21001 SYCOLIN RD STE 180
Practice Address - Street 2:
Practice Address - City:ASHBURN
Practice Address - State:VA
Practice Address - Zip Code:20147-4074
Practice Address - Country:US
Practice Address - Phone:703-687-4363
Practice Address - Fax:703-723-7470
Is Sole Proprietor?:No
Enumeration Date:2024-07-03
Last Update Date:2024-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0001262091163W00000X
VA0024190077363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1588400063Medicaid