Provider Demographics
NPI:1699968172
Name:LEE, JAMIE QUAN (BSN, RN, MSN, CFNP)
Entity type:Individual
Prefix:
First Name:JAMIE
Middle Name:QUAN
Last Name:LEE
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Gender:F
Credentials:BSN, RN, MSN, CFNP
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Mailing Address - Street 1:855 MANHATTAN BEACH BLVD
Mailing Address - Street 2:SUITE #201
Mailing Address - City:MANHATTAN BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90266-4965
Mailing Address - Country:US
Mailing Address - Phone:310-939-1893
Mailing Address - Fax:310-939-7861
Practice Address - Street 1:855 MANHATTAN BEACH BLVD
Practice Address - Street 2:SUITE #201
Practice Address - City:MANHATTAN BEACH
Practice Address - State:CA
Practice Address - Zip Code:90266-4965
Practice Address - Country:US
Practice Address - Phone:310-939-1893
Practice Address - Fax:310-939-7861
Is Sole Proprietor?:No
Enumeration Date:2007-08-20
Last Update Date:2007-08-20
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CA15861363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily