Provider Demographics
NPI:1700858974
Name:YOUNG, RAINA L (MD)
Entity Type:Individual
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First Name:RAINA
Middle Name:L
Last Name:YOUNG
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Gender:F
Credentials:MD
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Mailing Address - Street 1:8170 33RD AVENUE SOUTH
Mailing Address - Street 2:MS 21110Q
Mailing Address - City:BLOOMINGTON
Mailing Address - State:MN
Mailing Address - Zip Code:55425-4516
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1654 DIFFLEY RD STE 100
Practice Address - Street 2:
Practice Address - City:EAGAN
Practice Address - State:MN
Practice Address - Zip Code:55122-2237
Practice Address - Country:US
Practice Address - Phone:651-641-3900
Practice Address - Fax:651-641-3904
Is Sole Proprietor?:No
Enumeration Date:2006-02-02
Last Update Date:2021-03-17
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Provider Licenses
StateLicense IDTaxonomies
MN43091207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN667683900Medicaid
H23707Medicare UPIN