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General NPI Number Information
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NPI Number | 1851005771
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Entity Type | Individual
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Provider Name | PEYTEN YOUNG PA-C
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Gender | Female
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Dates
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Enumeration Date | 01/06/2023
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Last Update Date | 03/24/2025
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Provider Practice Location Address
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Address Line | 2070 BIDDLE AVE STE 200
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City | WYANDOTTE
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State | MI
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Zip | 48192-4080
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Country | US
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Telephone | 734-246-6000
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Fax |
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Provider Business Mailing Address
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Address Line | 370 120TH AVE STE 20
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City | HOLLAND
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State | MI
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Zip | 49424-2196
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Country | US
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Telephone | 616-396-5855
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 5601011579
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License Number State | MI
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