Healthcare Provider Details

I. General information

NPI: 1295779304
Provider Name (Legal Business Name): M. ELIZABETH M. YOUNGER CPNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/16/2006
Last Update Date: 12/03/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

JOHNS HOPKINS HOSPITAL CMSC 1102 600 NORTH WOLFE STREET
BALTIMORE MD
21287
US

IV. Provider business mailing address

11 CORNFIELD CT
REISTERSTOWN MD
21136-1635
US

V. Phone/Fax

Practice location:
  • Phone: 410-955-5883
  • Fax: 410-955-0229
Mailing address:
  • Phone: 410-833-0278
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License NumberR164615
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: