Provider Demographics
NPI:1932446853
Name:YOUNG, DONNA (DEM)
Entity Type:Individual
Prefix:
First Name:DONNA
Middle Name:
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:PO BOX 51
Mailing Address - Street 2:
Mailing Address - City:LAPOINT
Mailing Address - State:UT
Mailing Address - Zip Code:84039-0051
Mailing Address - Country:US
Mailing Address - Phone:435-724-1700
Mailing Address - Fax:
Practice Address - Street 1:16392 DEEP CREEK
Practice Address - Street 2:
Practice Address - City:LAPOINT
Practice Address - State:UT
Practice Address - Zip Code:84039-0051
Practice Address - Country:US
Practice Address - Phone:435-724-1700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-11
Last Update Date:2013-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175M00000XOther Service ProvidersMidwife, Lay