MEDICARE: CHRISTIAN ELAINE YOUNG I STNA

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
1	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1588065619
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTIAN ELAINE YOUNG I STNA

Provider Business Mailing Address
First Line	:	508 BACON AVE
Second Line	:
City	:	AKRON
State	:	OH
Zip	:	44320-2113
Country	:	US
Telephone Number	:	330-245-7061
Fax Number	:

Provider Business Practice Location Address
First Line	:	508 BACON AVE
Second Line	:
City	:	AKRON
State	:	OH
Zip	:	44320-2113
Country	:	US
Telephone Number	:	330-245-7061
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/08/2014
Last Update Date	:	09/08/2014

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