Individual
JUSTIN LEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
711 MARSHALL ST, LEAVENWORTH, KS 66048-3235
(913) 684-1100
(913) 684-1239
Mailing address
PO BOX 410272, KANSAS CITY, MO 64141-0272
(913) 234-1350
(913) 234-1108
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
13072095072
KS
367500000X
Certified Registered Nurse Anesthetist
Primary
557247
KS
Other
Enumeration date
03/03/2014
Last updated
06/19/2014
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