Provider Demographics
NPI:1376902890
Name:YOUNG, ELIZABETH ANN (CNIM)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:ANN
Last Name:YOUNG
Suffix:
Gender:F
Credentials:CNIM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:6298 VETERANS PARKWAY
Mailing Address - Street 2:SUITE 5A
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31909-8068
Mailing Address - Country:US
Mailing Address - Phone:706-320-0927
Mailing Address - Fax:
Practice Address - Street 1:6298 VETERANS PKWY
Practice Address - Street 2:SUITE 5A
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31909-8068
Practice Address - Country:US
Practice Address - Phone:706-320-0927
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-02-11
Last Update Date:2016-02-11
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZE0600XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherElectroneurodiagnostic
No246ZE0500XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherEEG