Provider Demographics
NPI:1518911866
Name:YOUNG, SHERYL (ARNP)
Entity Type:Individual
Prefix:
First Name:SHERYL
Middle Name:
Last Name:YOUNG
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4821 SW 9TH ST
Mailing Address - Street 2:
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50315-3802
Mailing Address - Country:US
Mailing Address - Phone:515-262-8471
Mailing Address - Fax:515-266-9783
Practice Address - Street 1:4821 SW 9TH STREET
Practice Address - Street 2:
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50315-3802
Practice Address - Country:US
Practice Address - Phone:515-262-8471
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-20
Last Update Date:2012-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA052278363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA719260339Medicare PIN
44244Medicare ID - Type UnspecifiedMEDICARE NONBILLIN
S53875Medicare UPIN