Provider Demographics
NPI:1508917774
Name:YOUNG, MARY NORFLEET (RNCS)
Entity Type:Individual
Prefix:MS
First Name:MARY
Middle Name:NORFLEET
Last Name:YOUNG
Suffix:
Gender:F
Credentials:RNCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 OAKLAND AVE
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:02476-5915
Mailing Address - Country:US
Mailing Address - Phone:781-646-1378
Mailing Address - Fax:
Practice Address - Street 1:4 MUZZEY ST
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:MA
Practice Address - Zip Code:02421-5220
Practice Address - Country:US
Practice Address - Phone:781-646-2324
Practice Address - Fax:781-648-2179
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-15
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN144255PC364SP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP0809XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health, Adult
Provider Identifiers
StateIdentifier IDID TypeIssuer
MANS0050Medicare ID - Type Unspecified
MAPN0313Medicare UPIN