Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0200X | Nurse Practitioner - Pediatrics | 0024146467 | VA |
NPI | 1013153220 |
---|---|
Provider Name | Dr. Adele E Young |
First Address | Woodbridge, VA 22192-8323 |
Second Address | Woodbridge, VA 22192-8323 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/12/2008 |
Last Update Date | 03/05/2012 |