Provider Demographics
NPI:1043599855
Name:YOUNG, TONETTE (LPN)
Entity Type:Individual
Prefix:MRS
First Name:TONETTE
Middle Name:
Last Name:YOUNG
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:249 EHRMAN AVE # 1
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45220-1313
Mailing Address - Country:US
Mailing Address - Phone:513-221-0635
Mailing Address - Fax:513-221-3693
Practice Address - Street 1:249 EHRMAN AVE # 1
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45220-1313
Practice Address - Country:US
Practice Address - Phone:513-221-0635
Practice Address - Fax:513-221-3693
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-10
Last Update Date:2011-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH083140164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse