Provider Demographics
NPI:1750276028
Name:YOUNG, TIFFANY ANN (CNM)
Entity type:Individual
Prefix:
First Name:TIFFANY
Middle Name:ANN
Last Name:YOUNG
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1835
Mailing Address - Street 2:
Mailing Address - City:HILO
Mailing Address - State:HI
Mailing Address - Zip Code:96721-1835
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:16-1077 OOAA RD
Practice Address - Street 2:
Practice Address - City:MOUNTIAN VIEW
Practice Address - State:HI
Practice Address - Zip Code:96771
Practice Address - Country:US
Practice Address - Phone:808-557-8188
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-09
Last Update Date:2025-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIAPRN-4215176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife