Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0000X | Nurse Practitioner - Neonatal | 26NN077405 | NJ |
N | 363LN0005X | Nurse Practitioner - Neonatal (Critical Care) | 26NN077405 | NJ |
NPI | 1083875322 |
---|---|
Provider Name | Mrs. Jodi Ellen Young |
First Address | New Brunswick, NJ 08901-1766 |
Second Address | New Brunswick, NJ 08901-1766 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/06/2008 |
Last Update Date | 20/08/2013 |