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General NPI Number Information
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NPI Number | 1912208117
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Entity Type | Individual
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Provider Name | OLIVIA S YOUNG CNM
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Gender | Female
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Dates
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Enumeration Date | 11/04/2010
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Last Update Date | 09/04/2024
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Provider Practice Location Address
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Address Line | 4417 N 6TH ST
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City | PHILADELPHIA
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State | PA
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Zip | 19140-2319
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Country | US
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Telephone | 215-302-3600
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Fax | 215-329-2369
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Provider Business Mailing Address
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Address Line | 301 LIPPINCOTT DR STE 410
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City | MARLTON
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State | NJ
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Zip | 08053-4197
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Country | US
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Telephone | 856-355-0340
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Fax | 856-355-0330
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | RN618861
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 176B00000X
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Taxonomy Name | Midwife
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License Number | 25ME00068200
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License Number State | NJ
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Taxonomy #3
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Taxonomy Code | 367A00000X
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Taxonomy Name | Advanced Practice Midwife
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License Number | MW010530
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License Number State | PA
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Taxonomy #4
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Taxonomy Code | 367A00000X
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Taxonomy Name | Advanced Practice Midwife
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License Number | 25ME00068200
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License Number State | NJ
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