Individual
MS. JENNIFER LANG REE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.N.P.
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
11027
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
260026968
TAX IDENTIFICATION NUMBER
CA
05
—
GR0075020
—
CA
01
—
ZHCPP486
BLUE CROSS OF CALIFORNIA
CA
01
—
ZZZ52949Z
BLUE SHIELD OF CALIFORNIA
CA
Enumeration date
06/22/2005
Last updated
01/27/2012
Update your record
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