Provider Demographics
NPI:1639813033
Name:YOUNG, PAMELA (RN)
Entity Type:Individual
Prefix:MRS
First Name:PAMELA
Middle Name:
Last Name:YOUNG
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1414 S GREEN RD STE 307
Mailing Address - Street 2:
Mailing Address - City:SOUTH EUCLID
Mailing Address - State:OH
Mailing Address - Zip Code:44121-3976
Mailing Address - Country:US
Mailing Address - Phone:216-465-3314
Mailing Address - Fax:
Practice Address - Street 1:1414 S GREEN RD STE 307
Practice Address - Street 2:
Practice Address - City:SOUTH EUCLID
Practice Address - State:OH
Practice Address - Zip Code:44121-3976
Practice Address - Country:US
Practice Address - Phone:216-340-7484
Practice Address - Fax:216-777-2063
Is Sole Proprietor?:No
Enumeration Date:2022-04-22
Last Update Date:2022-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN264506163WA0400X, 163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health
No163WA0400XNursing Service ProvidersRegistered NurseAddiction (Substance Use Disorder)