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KELLEY MARIE YOUNG FNP

Family >> Nurse Practitioner >> Physician Assistants & Advanced Practice Nursing Providers

Registrant NPI Number: 1346413309

Individual Registrant:
 KELLEY MARIE YOUNG FNP
Gender: F
Sole Proprietor

Location and contact information for practice:
12520 CROCKERY CREEK DRIVE  RAVENNA, MI 49451 US
Tel: 231-853-2954  Fax: 231-853-6089

Contact information for business:
12520 CROCKERY CREEK DRIVE P.O. BOX 179 RAVENNA, MI 49451-0179 US
Tel: 231-853-2954  Fax: 231-853-6089

Registration Information:
NPI: 1346413309
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y363LF0000XPhysician Assistants & Advanced Practice Nursing Providers
Nurse Practitioner
Family
MI4704210304

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




HEALTH CARE JOBS MI - Page 1



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