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NPI Code Detail

MEDICARE: LEANDRA YOUNG

MEDICARE:   LEANDRA  YOUNG
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
1163W00000XRegistered Nurse402164OH

General Provider Information

NPI Number : 1982013553
Entity Type Code : Individual
Provider Name (Legal Business Name) : LEANDRA YOUNG
Provider Business Mailing Address
First Line : 4736 E 104TH ST
Second Line :
City : GARFIELD HEIGHTS
State : OH
Zip : 44125-1573
Country : US
Telephone Number : 216-513-9709
Fax Number :
Provider Business Practice Location Address
First Line : 4736 E 104TH ST
Second Line :
City : GARFIELD HEIGHTS
State : OH
Zip : 44125-1573
Country : US
Telephone Number : 216-513-9709
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/08/2014
Last Update Date : 08/08/2014

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Directions to “ LEANDRA YOUNG ” Practice Location

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