Provider Demographics
NPI:1033503008
Name:YOUNKER, KAITLIN BROOKE
Entity Type:Individual
Prefix:
First Name:KAITLIN
Middle Name:BROOKE
Last Name:YOUNKER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1415 COCONINO RD
Mailing Address - Street 2:#310
Mailing Address - City:AMES
Mailing Address - State:IA
Mailing Address - Zip Code:50014-8034
Mailing Address - Country:US
Mailing Address - Phone:641-420-0029
Mailing Address - Fax:
Practice Address - Street 1:1415 COCONINO RD UNIT 310
Practice Address - Street 2:
Practice Address - City:AMES
Practice Address - State:IA
Practice Address - Zip Code:50014-8034
Practice Address - Country:US
Practice Address - Phone:641-420-0029
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-26
Last Update Date:2015-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer