Individual
JENNIFER A. LEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
1860 TOWN CENTER DR STE G100, RESTON, VA 20190-5897
(703) 639-3100
Mailing address
3998 FAIR RIDGE DR, STE 300, FAIRFAX, VA 22033-2907
(703) 295-9360
(703) 766-9725
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
0024169228
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1659678019
—
VA
Enumeration date
02/22/2011
Last updated
10/01/2020
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