Provider Demographics
NPI:1437966199
Name:LEE, ESTHER PAK (APRN)
Entity type:Individual
Prefix:
First Name:ESTHER
Middle Name:PAK
Last Name:LEE
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14635 THERA WAY
Mailing Address - Street 2:
Mailing Address - City:CENTREVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:20120-1606
Mailing Address - Country:US
Mailing Address - Phone:703-989-8214
Mailing Address - Fax:
Practice Address - Street 1:1851 N GEORGE MASON DR STE 3A
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22207-1953
Practice Address - Country:US
Practice Address - Phone:703-717-4792
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-16
Last Update Date:2025-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0001280102163WG0100X
VA0024192493363LP2300X, 363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No163WG0100XNursing Service ProvidersRegistered NurseGastroenterology
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care