MEDICARE: LISA YOUNT RN

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	163W00000X	Registered Nurse	4704423716	MI

General Provider Information

NPI Number	:	1699607663
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LISA YOUNT RN

Provider Business Mailing Address
First Line	:	10599 PODUNK AVE NE
Second Line	:
City	:	GREENVILLE
State	:	MI
Zip	:	48838-8325
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	10599 PODUNK AVE NE
Second Line	:
City	:	GREENVILLE
State	:	MI
Zip	:	48838-8325
Country	:	US
Telephone Number	:	616-446-2169
Fax Number	:

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

Provider Enumeration Date	:	06/02/2026
Last Update Date	:	06/02/2026

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Directions to “ LISA YOUNT RN” Practice Location

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