Healthcare Provider Details

I. General information

NPI: 1982933099
Provider Name (Legal Business Name): SHEILA M YOUNG ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/18/2009
Last Update Date: 12/18/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

52 STILES RD SUITE 110
SALEM NH
03079-4807
US

IV. Provider business mailing address

52 STILES RD SUITE 110
SALEM NH
03079-4807
US

V. Phone/Fax

Practice location:
  • Phone: 603-898-5082
  • Fax: 603-890-5453
Mailing address:
  • Phone: 603-898-5082
  • Fax: 603-890-5453

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number062054-23
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: