Provider Demographics
NPI:1518313923
Name:YOUNG, VALERIE LYNN
Entity Type:Individual
Prefix:
First Name:VALERIE
Middle Name:LYNN
Last Name:YOUNG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4258 TOWNSHIP ROAD 99
Mailing Address - Street 2:
Mailing Address - City:MOUNT GILEAD
Mailing Address - State:OH
Mailing Address - Zip Code:43338-9742
Mailing Address - Country:US
Mailing Address - Phone:614-778-5260
Mailing Address - Fax:
Practice Address - Street 1:4258 TOWNSHIP ROAD 99
Practice Address - Street 2:
Practice Address - City:MOUNT GILEAD
Practice Address - State:OH
Practice Address - Zip Code:43338-9742
Practice Address - Country:US
Practice Address - Phone:614-778-5260
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-05
Last Update Date:2016-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0157635OtherMCD