HEEJUN LEE - NPI 1669107900 - Nurse Practitioner in Santa Rosa, CA

Q: What is Heejun Lee's NPI number?

The NPI number for Heejun Lee is 1669107900. It was assigned to this individual provider in the NPPES registry on July 20, 2022.

Q: What is Heejun Lee's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Pediatrics, with taxonomy code 363LP0200X.

Q: When was this NPI record last updated?

The NPPES record for Heejun Lee was last updated on August 31, 2022. NPI Profile syncs with the weekly NPPES data releases published by CMS.

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About Heejun Lee NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

HEEJUN LEE (NPI 1669107900) is an individual pediatrics provider in Santa Rosa, California, licensed in California (95022405) and active in the NPI registry since July 2022.

NPPES Registry Identity

NPI1669107900

Entity TypeIndividualFemale

Primary Taxonomy363LP0200X

Provider Legal NameHEEJUN LEE

Location Address711 STONY POINT RD STE 17Santa Rosa, CA 95407-6848

Mailing Address711 Stony Point Rd Ste 17Santa Rosa, CA 95407-6848 · (707) 578-2005

Phone(707) 303-3600

Sole ProprietorNo

Enumeration DateJuly 20, 2022

Last NPPES UpdateAugust 31, 20222 updates tracked since enumeration

NPPES CertifiedAugust 31, 2022

✔ NPI 1669107900 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse Practitioner · PediatricsPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LP0200X

License✔ Licensed in CA · 95022405

Also ListedRegistered NurseTaxonomy 163W00000X · License 95251430 (CA)

711 STONY POINT RD STE 17, Santa Rosa, CA 95407

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Other Providers at the Same Location NPPES 6

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MADISON NICHOLE YUNGERT

Pediatrics