Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363L00000X | Nurse Practitioner | 341801 | NY |
Y | 363LC0200X | Nurse Practitioner - Critical Care Medicine | 341801 | NY |
NPI | 1518487487 |
---|---|
Provider Name | Melissa Joan Young |
First Address | Welland, ONTARIO L3B 5N7 |
Second Address | Lancaster, NY 14086-3430 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/06/2017 |
Last Update Date | 29/08/2019 |