Healthcare Provider Details

I. General information

NPI: 1669182598
Provider Name (Legal Business Name): PAULA LEE MCNEIL YOUNG PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/01/2022
Last Update Date: 03/07/2023
Certification Date: 12/01/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2802 GRAND AVE
GLENWOOD SPRINGS CO
81601-4428
US

IV. Provider business mailing address

515 28 3/4 RD
GRAND JUNCTION CO
81501-5016
US

V. Phone/Fax

Practice location:
  • Phone: 970-945-2583
  • Fax: 970-928-8852
Mailing address:
  • Phone: 970-683-7223
  • Fax: 970-683-7160

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAPN.0998167-NP
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: