Jin Kim Lee, A-GNP-C

Primary specialty

Occupational Health Nurse PractitionerTaxonomy code 363LX0106X

License

2022040714 Issued in MO

Practice address

11501 Page Service Dr
Saint Louis, MO 63146-3530

Phone

(314) 993-3014

Fax

(314) 993-2065

NPI assigned

Dec 14, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1670976000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705363200000",
    "number": "1821700592",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11501 PAGE SERVICE DR",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631463530",
            "telephone_number": "314-993-3014",
            "fax_number": "314-993-2065"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11501 PAGE SERVICE DR",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631463530",
            "telephone_number": "314-993-3014",
            "fax_number": "314-993-2065"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "JIN",
        "middle_name": "KIM",
        "credential": "A-GNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-12-14",
        "last_updated": "2024-01-16",
        "certification_date": "2024-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LX0106X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Occupational Health",
            "state": "MO",
            "license": "2022040714",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RN LICENSE NUMBER",
            "identifier": "2007026654",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CNP LICENSE NUMBER",
            "identifier": "2022040714",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Iris Lee, MD
• Jane Soohyun Lee, MD
• Janet Sojung Lee, MD
• Janine Benedetta Lee, MD
• Jason Lee, MD
• Jin-Moo Lee, MD
• John S Lee
• Julianna Caroline Lee
• Kenneth Alston Lee, DO
• Kil Soo Lee, MD

• Occupational Health Nurse Practitioner in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Occupational Health Nurse Practitioner in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2024; 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.