Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LA2100X | Nurse Practitioner - Acute Care | SP020158 | PA |
Y | 363LA2100X | Nurse Practitioner - Acute Care | SP02158 | PA |
N | 363LG0600X | Nurse Practitioner - Gerontology | SP02158 | PA |
NPI | 1013573765 |
---|---|
Provider Name | Marci Youngmark |
First Address | Pittsburgh, PA 15218-1204 |
Second Address | Pittsburgh, PA 15232-1327 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/05/2019 |
Last Update Date | 20/08/2021 |