Jordan Lee
Individual provider Active NPI Registered Nurse · Ama, LA
NPI 1902612435 · NPPES record last updated Dec 9, 2024
Key facts
- NPI
- 1902612435
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Registered Nurse 163W00000X
- License
- 919074 (MS)
- Practice address
- 151 Michael St
Ama, LA 70031-2151 - Phone
- (601) 218-6444
- NPI assigned
- Dec 9, 2024
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 919074 | MS | MD | Registered Nurse |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 919074 | MS | Yes |
Addresses
Primary practice location
151 Michael St
Ama, LA 70031-2151
Mailing address
151 Michael St
Ama, LA 70031-2151
Phone (601) 218-6444
Other providers in Ama, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 9, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.