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Individual

JENNY LEE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
3670 PARKER BLVD, SUITE 101, PUEBLO, CO 81008-2285
(719) 564-1544
(719) 924-1593
Mailing address
3670 PARKER BLVD, SUITE 101, PUEBLO, CO 81008-2285
(719) 564-1544

Taxonomy

Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
43172
CO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
41672381
CO
01
P00986961
RAILROAD MEDICARE
CO
Enumeration date
01/26/2007
Last updated
07/19/2013
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