Healthcare Provider Details

I. General information

NPI: 1346153483
Provider Name (Legal Business Name): HOLLY YOUNG CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/28/2026
Last Update Date: 09/28/2026
Certification Date: 09/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7345 KINGSGATE WAY
WEST CHESTER OH
45069-2453
US

IV. Provider business mailing address

814 OAK GROVE RD
MARTINSVILLE OH
45146-8017
US

V. Phone/Fax

Practice location:
  • Phone: 513-777-1333
  • Fax:
Mailing address:
  • Phone: 937-725-8633
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAPRN.CNP.0043472
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: