Provider Demographics
NPI:1437894433
Name:YOUNG, KAYLA JILL (CPM, RM)
Entity Type:Individual
Prefix:
First Name:KAYLA
Middle Name:JILL
Last Name:YOUNG
Suffix:
Gender:F
Credentials:CPM, RM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:730 BUTTE PASS DR
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80526-3570
Mailing Address - Country:US
Mailing Address - Phone:951-552-5019
Mailing Address - Fax:
Practice Address - Street 1:730 BUTTE PASS DR
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80526-3570
Practice Address - Country:US
Practice Address - Phone:951-552-5019
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-03
Last Update Date:2022-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COMWR.0000206176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife