MS. KYOUNG KELLY LEE NP NPI 1790765139

NPI Information

NPI: 1790765139
Provider Name: MS. KYOUNG KELLY LEE, NP
Classification: Nurse Practitioner - 363LX0001X
Entity Type: Individual

Specialization: Obstetrics & Gynecology

Address:
3300 WEST CENTRE AVE
BRONSON OB/GYN ASSOCIATES
PORTAGE, MI
ZIP 49024
Phone: (269) 327-2211
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MS. Kyoung Kelly Lee, NP is an obstetrics and gynecology nurse practitioner in Portage, MI. MS. Kyoung Kelly Lee, NP NPI is 1790765139. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

3300 WEST CENTRE AVE
BRONSON OB/GYN ASSOCIATES
PORTAGE, MI
ZIP 49024
Phone: (269) 327-2211
Fax: (269) 327-0273

The enumeration date for this NPI number is 1/20/2006 and was last updated on 7/8/2007.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LX0001X	Nurse Practitioner	Obstetrics & Gynecology	4704247830	MICHIGAN	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	M97850009	MEDICARE ID-TYPE UNSPECIFIED	MICHIGAN
2	4770217	MEDICAID	MICHIGAN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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