Most Relevant Information
Provider Data
| NPI Number: | 1003461831 |
| Provider Name: | JESSICA L LEE APN |
| Entity Type: | Individual |
| Taxonomy Code: | 363LF0000X |
| Specialty: | Nurse Practitioner |
| License Number: | 209019780 |
Most Important Dates
| Enumeration Date: | 08/08/2019 |
| Last Updated: | 04/21/2021 |
Provider Practice Location
350 W CARPENTER ST
SPRINGFIELD
IL
627024902
Practice Location Phone/Fax
| Phone: | 2175287541 |
| Fax: | 2175287144 |
Provider Mailing Location
1025 S 6TH ST
SPRINGFIELD
IL
627032403
Provider Mailing Phone/Fax
| Phone: | 2175287541 |
| Fax: |