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Individual

JARED WAYNE LEE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
RN, CRNA

Contact information

Practice address
400 E 3RD ST, DULUTH, MN 55805-1951
(218) 786-4459
Mailing address
400 E 3RD ST, DULUTH, MN 55805-1951
(218) 786-4459

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
R171578-9
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
44350700
WI
Enumeration date
06/03/2006
Last updated
07/08/2007
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