Miju Lee

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

AP130711 Issued in TX

Practice address

300 W Hospital Rd
Fort Gordon, GA 30905-5741

Phone

(706) 787-5811

NPI assigned

Feb 10, 2016

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Other names 1

• Miju Song Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• The Guidance Center, Inc

  • Community/Behavioral Health Agency
  • Leavenworth, KS
  • NPI 1912697186
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1455062400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787529600000",
    "number": "1083072680",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 W HOSPITAL RD",
            "city": "FORT GORDON",
            "state": "GA",
            "postal_code": "309055741",
            "telephone_number": "706-787-5811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 W HOSPITAL RD",
            "city": "FORT GORDON",
            "state": "GA",
            "postal_code": "309055741",
            "telephone_number": "706-787-5811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "MIJU",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-02-10",
        "last_updated": "2026-08-24",
        "certification_date": "2026-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "863440",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "F0116958",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "AP130711",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MIJU",
            "last_name": "SONG",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Daniel Joe Lavengood
• Constance Ann Lavieri-Reynolds, M.D.
• Scott Jay Lawlis, PA-C
• Carla B. Lee, MD
• Daniel Fields Lee, DO
• Scott Allen Lemmons, D.D.S.
• Casey Patrick Leser, DDS
• Lindsay Leskanich
• Claude Eugene Lett III, PA-C
• Tiffany Ramona Lewis, D.M.D

• Nurse Practitioner in Fort Gordon, GA
• Providers in Fort Gordon, GA by specialty
• Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.