MS. KYOUNG KELLY LEE (NPI# 1790765139) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790765139 |
| Entity Type | Individual |
| Full Name | MS. KYOUNG KELLY LEE |
| Other Name | KYOUNG-EUN KELLY LEE |
| Credential | NP |
| Practice Address |
3300 West Centre Ave Bronson Ob/gyn Associates Portage MI 49024 |
| Mailing Address |
Po Box 42 601 John Street Kalamazoo MI 49007 |
| Practice Telephone | 2693272211 |
| Practice Fax Number | 2693270273 |
| Mailing Telephone | 2693417806 |
| Mailing Fax Number | 2693418743 |
| Enumeration Date | 2006-01-20 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | X |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LX0001X |
Nurse Practitioner Specialization: Obstetrics & Gynecology |
4704247830 | MI | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | 4770217 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265761514 | Kyoung Lee | Pharmacist | 504 State Hwy 71 W, Bastrop, TX 78602 | 2009-12-16 |
| 1225286560 | Kyoung Shin Lee | Acupuncturist | 1508 W Verdugo Ave Ste A, Burbank, CA 91506-2446 | 2008-08-28 |
| 1841661667 | Kyoung Lee | Counselor | 1233 Main St, Holyoke, MA 01040-5381 | 2015-10-20 |
| Street Address |
3300 WEST CENTRE AVE BRONSON OB/GYN ASSOCIATES |
| City | PORTAGE |
| State | MI |
| Zip Code | 49024 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134774524 | Antonio Richard Barron | Physician Assistant | 5717 Oakland Dr Ste A, Portage, MI 49024 | 2019-08-03 |
| 1699279240 | Julie Lynn Griffin | Specialist/Technologist | Portage Northern High School, 1000 Idaho Ave, Portage, MI 49024 | 2018-03-20 |
| 1194255711 | Brittany Lynn Finkler | Audiologist | 576 Romence Rd Ste 121, Portage, MI 49024 | 2017-06-15 |
| 1164881207 | Family & Children Services, Inc. | Clinic/Center | 1302 W Milham Ave, Portage, MI 49024 | 2016-02-17 |
| 1497127716 | Huber Counseling, LLC | Counselor | 1591 West Centre Ave, Suite 102, Portage, MI 49024 | 2015-10-26 |
| 1659757466 | Marie Porter | Rehabilitation Practitioner | 5724 Alten St, Portage, MI 49024 | 2015-08-04 |
| 1063824860 | George Hughes | General Practice | 6630 Sunburst Dr, Portage, MI 49024 | 2014-05-28 |
| 1922358407 | Kimberly Lynn Ellrich | Speech-Language Pathologist | Storypoint, 3951 W Milham Ave, Portage, MI 49024 | 2012-09-12 |
| 1942593744 | Shamika Hall, Ph.d. & Associates, Pllc | Community/Behavioral Health | 7901 S. 12th St., Suite 201, Portage, MI 49024 | 2011-05-26 |
| 1306142815 | Jody Lynn Wrathall | Dentist | 3020 Old Centre Rd, Portage, MI 49024 | 2011-01-31 |
| Find all providers in zip 49024 | ||||
| Taxonomy Code | 363LX0001X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Obstetrics & Gynecology |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063924926 | Jennifer Ann Soper | Nurse Practitioner | 3300 W Centre Ave, Portage, MI 49024-4666 | 2017-11-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255607032 | Maureen M Westfall | Nurse Practitioner | 4200 Whitehall Dr Ste 330, Ann Arbor, MI 48105-9694 | 2012-03-27 |
| 1306121660 | Julie Sokolow | Nurse Practitioner | 317 S Drake Rd Ste B, Kalamazoo, MI 49009-1171 | 2011-10-19 |
| 1073835302 | Leah Foucart | Nurse Practitioner | 6920 Tamarack Ln, Holly, MI 48442-9157 | 2010-03-01 |
| 1265547749 | Karen J Pociluyko | Nurse Practitioner | 205 N Hintz Rd, Owosso, MI 48867-9019 | 2006-08-21 |
| 1790206019 | Christy Lynn Klieman | Nurse Practitioner | 1701 South Boulevard, East, Suite 200, Rochester Hills, MI 48307 | 2017-06-28 |
| 1942613252 | Lorrie Lorraine Youngs | Nurse Practitioner | 2012 E Preston St, Mt Pleasant, MI 48858-8990 | 2014-06-04 |
| 1861814220 | Jeanna Mastracci | Nurse Practitioner | 44344 Dequindre Rd, Sterling Heights, MI 48314-1038 | 2014-01-19 |
| 1639517758 | Sarah Sharp | Nurse Practitioner | 8333 Felch St Ste 202, Zeeland, MI 49464-2609 | 2013-06-11 |
| 1962840397 | Shelly L Betancourt | Nurse Practitioner | 639 E Main St, Carson City, MI 48811-9795 | 2013-06-07 |
| 1952647083 | Mary Lynne Barringer | Nurse Practitioner | 18101 Oakwood Blvd, Dearborn, MI 48124-4089 | 2012-12-18 |
| Find all providers with the same taxonomy | ||||
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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.