Healthcare Provider Details

I. General information

NPI: 1639124076
Provider Name (Legal Business Name): MELISSA M YOUNG RN MS CPNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MELISSA MICHELLE OZUNA RN

II. Dates (important events)

Enumeration Date: 05/24/2006
Last Update Date: 09/02/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

839 W CONGRESS ST
TUCSON AZ
85745-2819
US

IV. Provider business mailing address

839 W CONGRESS ST
TUCSON AZ
85745-2819
US

V. Phone/Fax

Practice location:
  • Phone: 520-670-3914
  • Fax: 520-670-3714
Mailing address:
  • Phone: 520-670-3914
  • Fax: 520-670-3714

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0200X
TaxonomyPediatric Registered Nurse
License NumberRN 107098
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: