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NPI Code Detail

MEDICARE: BERYL HAZEL YOUNKIN

MEDICARE:   BERYL HAZEL YOUNKIN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1374U00000XHome Health Aide

General Provider Information

NPI Number : 1508468489
Entity Type Code : Individual
Provider Name (Legal Business Name) : BERYL HAZEL YOUNKIN
Provider Business Mailing Address
First Line : 3272 E FAIRFAX RD
Second Line :
City : CLEVELAND HEIGHTS
State : OH
Zip : 44118-4206
Country : US
Telephone Number : 612-750-3711
Fax Number :
Provider Business Practice Location Address
First Line : 3272 E FAIRFAX RD
Second Line :
City : CLEVELAND HEIGHTS
State : OH
Zip : 44118-4206
Country : US
Telephone Number : 612-750-3711
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/14/2020
Last Update Date : 11/14/2020

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Directions to “ BERYL HAZEL YOUNKIN ” Practice Location

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