Individual
MIKI CHU LAM LEE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN, CDCES
Contact information
Practice address
3900 TELEPORT BLVD UNIT 140063, IRVING, TX 75014-0017
(312) 933-0671
Mailing address
PO BOX 140063, IRVING, TX 75014-0063
(312) 933-0761
Taxonomy
Speciality
Code
Description
License number
State
163WD0400X
Diabetes Educator Registered Nurse
041410077
IL
163WD0400X
Diabetes Educator Registered Nurse
Primary
267957
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000000000
—
IL
Enumeration date
03/13/2021
Last updated
04/23/2024
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