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General NPI Number Information
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NPI Number | 1528616471
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Entity Type | Individual
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Provider Name | AMELIA YOUNG CRNA
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Gender | Female
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Dates
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Enumeration Date | 09/03/2019
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Last Update Date | 09/03/2019
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Provider Practice Location Address
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Address Line | 1720 LOUISIANA BLVD NE STE 401
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City | ALBUQUERQUE
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State | NM
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Zip | 87110-7020
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Country | US
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Telephone |
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Fax |
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Provider Business Mailing Address
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Address Line | 3350 N 225 W
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City | PLEASANT VIEW
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State | UT
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Zip | 84414-1568
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Country | US
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Telephone | 801-452-1668
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Fax |
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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 | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 129108
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License Number State | UT
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