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General NPI Number Information
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NPI Number | 1164239471
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Entity Type | Organization
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Legal Business Name | YOUNG COMMUNITY MEDICAL CARE PLLC
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Dates
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Enumeration Date | 12/11/2024
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Last Update Date | 12/11/2024
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Provider Practice Location Address
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Address Line | 2200 GREENE WAY
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City | LOUISVILLE
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State | KY
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Zip | 40220-4026
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Country | US
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Telephone | 502-644-4068
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Fax | 888-772-4611
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Provider Business Mailing Address
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Address Line | 2200 GREENE WAY
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City | LOUISVILLE
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State | KY
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Zip | 40220-4026
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Country | US
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Telephone | 502-644-4068
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Fax | 888-772-4611
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Authorized Official
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Title or Position | OWNER
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Name | JACQUE YOUNG
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Credential | NP
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Telephone | 502-644-4068
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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