Provider Demographics
NPI:1962950808
Name:LEE, YUEUN (NP-C)
Entity type:Individual
Prefix:
First Name:YUEUN
Middle Name:
Last Name:LEE
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8170 RANDOLPH WAY APT 302
Mailing Address - Street 2:
Mailing Address - City:ELLICOTT CITY
Mailing Address - State:MD
Mailing Address - Zip Code:21043-4919
Mailing Address - Country:US
Mailing Address - Phone:240-524-8284
Mailing Address - Fax:
Practice Address - Street 1:8114 SANDPIPER CIR STE 100
Practice Address - Street 2:
Practice Address - City:NOTTINGHAM
Practice Address - State:MD
Practice Address - Zip Code:21236-5901
Practice Address - Country:US
Practice Address - Phone:410-933-8101
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-21
Last Update Date:2024-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP131882363LF0000X
MDR241733363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily