Provider Demographics
NPI:1437835261
Name:YOUNG, MAKINZEY CATHERINE
Entity Type:Individual
Prefix:
First Name:MAKINZEY
Middle Name:CATHERINE
Last Name:YOUNG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:MAKINZEY
Other - Middle Name:
Other - Last Name:GEMAR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1318 11TH AVE S
Mailing Address - Street 2:
Mailing Address - City:FARGO
Mailing Address - State:ND
Mailing Address - Zip Code:58103-3004
Mailing Address - Country:US
Mailing Address - Phone:701-680-7431
Mailing Address - Fax:
Practice Address - Street 1:1318 11TH AVE S
Practice Address - Street 2:
Practice Address - City:FARGO
Practice Address - State:ND
Practice Address - Zip Code:58103-3004
Practice Address - Country:US
Practice Address - Phone:701-680-7431
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-26
Last Update Date:2023-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NDR53622163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse