| Jiwon Lee, | |
|
1950 S Scenic Ave Apt A307, Springfield, MO 65807-2158 | |
| (417) 619-1658 | |
| Not Available |
| Full Name | Jiwon Lee |
|---|---|
| Gender | Female |
| Speciality | Certified Registered Nurse Anesthetist (crna) |
| Experience | 3 Years |
| Location | 1950 S Scenic Ave Apt A307, Springfield, Missouri |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1437884327 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 163W00000X | Registered Nurse | 2014005304 (Missouri) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Banner - University Medical Center Phoenix | Phoenix, AZ | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Banner - University Hospital Based Physicians Llc | 1052614294 | 343 |
| Pca Anesthesia | 1658675558 | 54 |
| Entity Name | Banner - University Hospital Based Physicians LLC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1750751566 PECOS PAC ID: 1052614294 Enrollment ID: O20160122000508 |
| Entity Name | Pca Anesthesia |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1164804258 PECOS PAC ID: 1658675558 Enrollment ID: O20160215000555 |
| Mailing Address | Practice Location Address |
|---|---|
| Jiwon Lee, 1950 S Scenic Ave Apt A307, Springfield, MO 65807-2158 Ph: (417) 619-1658 | Jiwon Lee, 1950 S Scenic Ave Apt A307, Springfield, MO 65807-2158 Ph: (417) 619-1658 |
Ethel Marie Allison, RN, MPH, BSN, CDE Registered Nurse Medicare: Not Enrolled in Medicare Practice Location: 3801 S National Ave, Springfield, MO 65807 Phone: 417-269-4264 Fax: 417-269-4265 |
Jodie L Clinkenbeard, RN, BSN Registered Nurse Medicare: Not Enrolled in Medicare Practice Location: 1055 E Westchester Dr, Springfield, MO 65810 Phone: 417-877-8739 Fax: 417-877-8739 |
Sara Maples, Registered Nurse Medicare: Not Enrolled in Medicare Practice Location: 2626 W College Rd, Springfield, MO 65802 Phone: 417-869-8086 |
Laura Young, Registered Nurse Medicare: Not Enrolled in Medicare Practice Location: 1235 E Cherokee St, Springfield, MO 65804 Phone: 417-820-2000 |
Crystal Romay, R.N. Registered Nurse Medicare: Not Enrolled in Medicare Practice Location: 1110 N Fremont Ave, Springfield, MO 65802 Phone: 417-865-9090 Fax: 417-864-3226 |
Mrs. Donna M Mohl, FNP Registered Nurse Medicare: Not Enrolled in Medicare Practice Location: 4049 S Campbell Ave, Springfield, MO 65807 Phone: 417-890-5550 Fax: 417-889-6898 |
Kathleen Gail Newell-lewis, RN Registered Nurse Medicare: Not Enrolled in Medicare Practice Location: 2345 E. Cherokee, Springfield, MO 65803 Phone: 417-820-2856 |