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General NPI Number Information
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NPI Number | 1962446815
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Entity Type | Individual
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Provider Name | SUZANNE YOUNG
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Gender | Female
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Dates
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Enumeration Date | 06/15/2006
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Last Update Date | 02/12/2014
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Provider Practice Location Address
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Address Line | 3840 N SHERMAN DR
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City | INDIANAPOLIS
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State | IN
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Zip | 46226-4462
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Country | US
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Telephone | 317-541-3400
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 78158
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City | INDIANAPOLIS
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State | IN
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Zip | 46278-0158
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Country | US
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Telephone |
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 71000713A
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License Number State | IN
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