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General NPI Number Information
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NPI Number | 1780397513
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Entity Type | Organization
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Legal Business Name | J R YOUNG HEALTH EQUITY INSTITUTE
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Dates
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Enumeration Date | 12/26/2022
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Last Update Date | 12/26/2022
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Provider Practice Location Address
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Address Line | 2201 E REED RD # 1200
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City | GREENVILLE
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State | MS
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Zip | 38703-9449
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Country | US
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Telephone | 601-941-7181
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 3939
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City | GREENVILLE
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State | MS
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Zip | 38704-3939
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Country | US
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Telephone | 601-941-7181
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Fax |
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Authorized Official
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Title or Position | FOUNDER
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Name | DR. GERALDINE Q. YOUNG
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Credential | DNP, FNP-BC
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Telephone | 601-941-7181
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QP0904X
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Taxonomy Name | Federal Public Health Clinic/Center
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Taxonomy #3
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Taxonomy Code | 261QP0905X
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Taxonomy Name | State or Local Public Health Clinic/Center
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Taxonomy #4
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Taxonomy Code | 261QR1100X
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Taxonomy Name | Research Clinic/Center
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License Number |
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Taxonomy #5
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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