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Individual
JACQUELINE LEE
Active
Individual
JACQUELINE LEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
72041
WI
2080A0000X
Pediatric Adolescent Medicine Physician
72041
WI
208M00000X
Hospitalist Physician
Primary
72041
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1831695006
—
WI
Enumeration date
04/04/2018
Last updated
10/08/2021
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