Provider Demographics
NPI:1326149519
Name:YOUNG, JO ANNE H (MD)
Entity Type:Individual
Prefix:
First Name:JO ANNE
Middle Name:H
Last Name:YOUNG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:JO ANNE
Other - Middle Name:H
Other - Last Name:VAN BURIK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:720 WASHINGTON AVE SE
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55414-2924
Mailing Address - Country:US
Mailing Address - Phone:612-672-7422
Mailing Address - Fax:
Practice Address - Street 1:909 FULTON ST SE
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55455-4800
Practice Address - Country:US
Practice Address - Phone:612-672-7422
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-26
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN41429207R00000X, 207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN1018894OtherPREFERREDONE
MN15G33VAOtherBLUE CROSS BLUE SHIELD
MN9200031OtherMEDICA - CHOICE
MN9200031OtherMEDICA - PRIMARY
MNHP28828OtherHEALTHPARTNERS
MT0051578Medicaid
MN124974OtherFAIRVIEW
MN123338OtherUCARE
MN818681OtherARAZ
MN9200031OtherMEDICA - PRIMARY
MN123338OtherUCARE
MN818681OtherARAZ