Provider Demographics
NPI:1356524102
Name:LEE, JANET LYNN (RN)
Entity type:Individual
Prefix:
First Name:JANET
Middle Name:LYNN
Last Name:LEE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:JANET
Other - Middle Name:LYNN
Other - Last Name:BRONKOWSKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:11345 DOUGLAS RD
Mailing Address - Street 2:
Mailing Address - City:TEMPERANCE
Mailing Address - State:MI
Mailing Address - Zip Code:48182-9770
Mailing Address - Country:US
Mailing Address - Phone:734-854-1889
Mailing Address - Fax:
Practice Address - Street 1:2151 E ERIE RD
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:MI
Practice Address - Zip Code:48133-9320
Practice Address - Country:US
Practice Address - Phone:734-317-7025
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-12-14
Last Update Date:2008-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704261446163W00000X
OH337150163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse