JEANNIE JISUN LEE (NPI# 1063079051) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063079051 |
| Entity Type | Individual |
| Full Name | JEANNIE JISUN LEE |
| Practice Address |
3601 4th St Stop 8321 Lubbock TX 79430-0002 |
| Practice Telephone | 8067433832 |
| Practice Fax Number | 8067432974 |
| Mailing Telephone | 8067433832 |
| Mailing Fax Number | 8067432974 |
| Enumeration Date | 2019-05-24 |
| Last Update Date | 2019-05-24 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 3601 4th St Rm 3a105, Lubbock, TX 794300002 | 8067433832 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972654440 | Jeannie S Lee | Physical Therapist | 1569 Chalcedony St Apt 7, San Diego, CA 92109-2113 | 2007-01-12 |
| 1811968951 | Jeannie Kim Lee | Pharmacist | 1295 N Martin Ave, Tucson, AZ 85721-0202 | 2006-01-27 |
| 1376191395 | Jeannie Sheng Lee | Student in an Organized Health Care Education/Training Program | 3333 E American Ave, Fresno, CA 93725-9247 | 2019-09-03 |
| 1649798430 | Jeannie Lee | Behavior Technician | 7613 Standish Pl, Rockville, MD 20855-2702 | 2017-08-31 |
| 1720127269 | Jeannie C Lee | Registered Nurse | 1500 Division St, Oregon City, OR 97045-1527 | 2007-02-05 |
| Street Address |
3601 4TH ST STOP 8321 |
| City | LUBBOCK |
| State | TX |
| Zip Code | 79430-0002 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619383056 | Doungporn Ruthirago | Psychiatry & Neurology | 3601 4th St Stop 8321, Department of Neurology, Lubbock, TX 79430-8321 | 2014-07-07 |
| 1205442399 | Werdah Hunain | Student in an Organized Health Care Education/Training Program | 3601 4th St Stop 8321, Lubbock, TX 79430-0002 | 2020-09-23 |
| 1548883283 | Yuanyuan Tan | Student in an Organized Health Care Education/Training Program | 3601 4th St Stop 8321, Lubbock, TX 79430-0002 | 2020-05-27 |
| 1780207621 | Roberto Manuel Hernandez Quintana | Student in an Organized Health Care Education/Training Program | 3601 4th St Stop 8321, Lubbock, TX 79430-8321 | 2020-05-27 |
| 1215599410 | Tulio Arnaldo Bueso | Student in an Organized Health Care Education/Training Program | 3601 4th St Stop 8321, Lubbock, TX 79430-8321 | 2019-07-08 |
| 1629635503 | Victor Carlos Montalvan | Student in an Organized Health Care Education/Training Program | 3601 4th St Stop 8321, Lubbock, TX 79430-8321 | 2019-05-25 |
| 1528547593 | Igor Queiroz Campos Arauj | Student in an Organized Health Care Education/Training Program | 3601 4th St Stop 8321, Lubbock, TX 79430-8321 | 2018-08-10 |
| 1053805432 | Amputch Karukote | Student in an Organized Health Care Education/Training Program | 3601 4th St Stop 8321, Lubbock, TX 79430-8321 | 2018-06-19 |
| 1609369990 | Jie Pan | Psychiatry & Neurology | 3601 4th St Stop 8321, Lubbock, TX 79430-8321 | 2018-06-11 |
| 1851815146 | Walter Rodrigo Duarte Celada | Student in an Organized Health Care Education/Training Program | 3601 4th St Stop 8321, Lubbock, TX 79430-8321 | 2017-07-28 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730702473 | Emily Bouffard | Student in an Organized Health Care Education/Training Program | 3601 4th Street Mail Stop 8143, Lubbock, TX 79430 | 2020-05-27 |
| 1891350310 | Erin Leigh Burton | Student in an Organized Health Care Education/Training Program | 3601 Fourth Street, Department of Surgery Ms 8312, Lubbock, TX 79430 | 2019-05-09 |
| 1851861439 | Zachery Brian Sneed | Counselor | 3b310, 3601 4th St Stop 6225, Lubbock, TX 79430 | 2018-11-27 |
| 1831683481 | Swagat Parajulee | Student in an Organized Health Care Education/Training Program | 3601 4th St., Stop 9410, Office 4b076, Lubbock, TX 79430 | 2018-06-18 |
| 1649711904 | William David Boothe Jr. | Dermatology | 3601 4th St Stop 6211, Lubbock, TX 79430 | 2017-03-19 |
| 1982144945 | Kazutaka Araki | Specialist/Technologist | 3601, 4th St, Lubbock, TX 79430 | 2017-02-24 |
| 1659725125 | Thomas Gregory Wyatt | Student in an Organized Health Care Education/Training Program | 3601 4th St Rm 3a122b, Lubbock, TX 79430 | 2016-04-20 |
| 1619391760 | Chinyere Mbagwu | General Practice | 3601 4th St # Ms 8143, Lubbock, TX 79430 | 2014-02-10 |
| 1982044111 | Eileen Mary Sprys | Family Medicine | 3601 4th St., Stop 8143, Lubbock, TX 79430 | 2013-07-02 |
| 1205196243 | Hilmi Alam | Family Medicine | Department of Family & Community Medicine, 3601 4th Street, Stop 8143, Lubbock, TX 79430 | 2012-05-24 |
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| Taxonomy Code | 390200000X |
| Grouping | Student, Health Care |
| Classification | Student in an Organized Health Care Education/Training Program |
| An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |
| Notes: [1/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427674399 | Nicole Lynn Rosteski | Student in an Organized Health Care Education/Training Program | 3101 96th St, Lubbock, TX 79423 | 2020-06-17 |
| 1942824214 | Kaka Leigh Adams | Student in an Organized Health Care Education/Training Program | 3601 4th St Ttuhsc Dept-pediatrics, Lubbock, TX 79430-0001 | 2020-06-03 |
| 1104440403 | Nadia Tello | Student in an Organized Health Care Education/Training Program | 3601 4th St Stop 8315, Lubbock, TX 79430-8315 | 2020-06-02 |
| 1154945517 | Nicholas Quigley | Student in an Organized Health Care Education/Training Program | Ttuhsc 3601 4th Street Stop 6211, Lubbock, TX 79430-0001 | 2020-06-02 |
| 1265056683 | Chandon C Loya | Student in an Organized Health Care Education/Training Program | Family Medicine Residency Program Ttu Hsc, 3601 4th Street Mail Stop 8143, Lubbock, TX 79430-0001 | 2020-06-01 |
| 1659995256 | Joshua Daniel Brogan | Student in an Organized Health Care Education/Training Program | Internal Med Dept Lbk Genl 3601 4th St Stop 9410, Lubbock, TX 79430-9410 | 2020-05-31 |
| 1932722873 | Aron Tidrick | Student in an Organized Health Care Education/Training Program | 3601 4th St Rm 1b350, Lubbock, TX 79430-0002 | 2020-05-27 |
| 1730702473 | Emily Bouffard | Student in an Organized Health Care Education/Training Program | 3601 4th Street Mail Stop 8143, Lubbock, TX 79430 | 2020-05-27 |
| 1235752098 | Shannon Corbitt | Student in an Organized Health Care Education/Training Program | 3601 Fourth Street Ttuhsc Department of Surgery Ms 8312, Lubbock, TX 79430-0001 | 2020-05-27 |
| 1104449917 | Jacob Burton | Student in an Organized Health Care Education/Training Program | Department of Anesthesiology 3601 4th St Ms 8182 1b350b, Lubbock, TX 79430-8182 | 2020-05-27 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.