Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | 431079 | KS |
NPI | 1013991413 |
---|---|
Provider Name | Dr. Courtney Younglove |
First Address | Shawnee, KS 66227-2223 |
Second Address | Overland Park, KS 66215-2306 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/11/2005 |
Last Update Date | 25/09/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
200326890A | (05) | KS |
200326890B | (05) | KS |
I31710 | (02) | KS |