MEDICARE: JENNIFER PYLE 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
1	363A00000X	Physician Assistant	0010-10153	NC

General Provider Information

NPI Number	:	1992331235
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNIFER PYLE YOUNG

Provider Business Mailing Address
First Line	:	3668 SHADOW RIDGE DR
Second Line	:
City	:	HIGH POINT
State	:	NC
Zip	:	27265-8403
Country	:	US
Telephone Number	:	740-294-1423
Fax Number	:

Provider Business Practice Location Address
First Line	:	3001 LYNDHURST AVE
Second Line	:
City	:	WINSTON SALEM
State	:	NC
Zip	:	27103-4026
Country	:	US
Telephone Number	:	336-765-0383
Fax Number	:

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

Provider Enumeration Date	:	03/18/2020
Last Update Date	:	10/01/2025

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