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General NPI Number Information
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NPI Number | 1124589551
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Entity Type | Individual
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Provider Name | EMILY LOUISE YOUNG PA-C
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Gender | Female
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Dates
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Enumeration Date | 03/28/2019
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Last Update Date | 01/23/2020
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Provider Practice Location Address
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Address Line | 6858 OLD DOMINION DR
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City | MC LEAN
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State | VA
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Zip | 22101-3899
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Country | US
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Telephone | 703-847-9800
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Fax | 703-356-7074
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Provider Business Mailing Address
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Address Line | 6858 OLD DOMINION DR
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City | MC LEAN
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State | VA
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Zip | 22101-3899
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Country | US
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Telephone | 703-847-9800
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Fax | 703-356-7074
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 0110-006770
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License Number State | VA
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