Provider Demographics
NPI:1700641867
Name:YOUNG, KYRSTEN MARIE (DEM)
Entity type:Individual
Prefix:
First Name:KYRSTEN
Middle Name:MARIE
Last Name:YOUNG
Suffix:
Gender:F
Credentials:DEM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6300 GREEN VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:GUYSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:45735-9489
Mailing Address - Country:US
Mailing Address - Phone:740-447-4275
Mailing Address - Fax:
Practice Address - Street 1:6300 GREEN VALLEY RD
Practice Address - Street 2:
Practice Address - City:GUYSVILLE
Practice Address - State:OH
Practice Address - Zip Code:45735-9489
Practice Address - Country:US
Practice Address - Phone:740-447-4275
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-19
Last Update Date:2024-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175M00000XOther Service ProvidersMidwife, Lay