Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | 41783 | CO |
N | 207QS0010X | Family Doctor - Sports Medicine | 41783 | CO |
NPI | 1043270903 |
---|---|
Provider Name | Linda E Young |
First Address | Greeley, CO 80631-5114 |
Second Address | Greeley, CO 80631-5114 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/03/2006 |
Last Update Date | 02/05/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
02528266 | (05) | CO |
I50242 | (02) | CO |