Provider Demographics
NPI:1083954549
Name:YOUNG, MAUREEN VALENTINE (PHYSICIAN ASSISTANT)
Entity Type:Individual
Prefix:MS
First Name:MAUREEN
Middle Name:VALENTINE
Last Name:YOUNG
Suffix:
Gender:F
Credentials:PHYSICIAN ASSISTANT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3701 JOHN PLATT DR
Mailing Address - Street 2:
Mailing Address - City:MOREHEAD CITY
Mailing Address - State:NC
Mailing Address - Zip Code:28557-4372
Mailing Address - Country:US
Mailing Address - Phone:252-622-4448
Mailing Address - Fax:
Practice Address - Street 1:3701 JOHN PLATT DR
Practice Address - Street 2:
Practice Address - City:MOREHEAD CITY
Practice Address - State:NC
Practice Address - Zip Code:28557-4372
Practice Address - Country:US
Practice Address - Phone:252-622-4448
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-02-20
Last Update Date:2013-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC101124363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical