Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LW0102X | Nurse Practitioner - Women's Health | 119532 | CO |
NPI | 1063615599 |
---|---|
Provider Name | Dr. Myra Lynne Young |
First Address | Boulder, CO 80305-7002 |
Second Address | Denver, CO 80203-2706 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/06/2007 |
Last Update Date | 08/07/2007 |