Provider Demographics
NPI:1154030237
Name:YOUNG, JULAYNE KAY (MSM, PA-C)
Entity type:Individual
Prefix:
First Name:JULAYNE
Middle Name:KAY
Last Name:YOUNG
Suffix:
Gender:F
Credentials:MSM, PA-C
Other - Prefix:
Other - First Name:JULAYNE
Other - Middle Name:
Other - Last Name:BRIGHAM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:24 FRANK LLOYD WRIGHT DR # J2000
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48105-9484
Mailing Address - Country:US
Mailing Address - Phone:734-747-6766
Mailing Address - Fax:
Practice Address - Street 1:212 S MAIN ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:MI
Practice Address - Zip Code:49230-9114
Practice Address - Country:US
Practice Address - Phone:517-592-8033
Practice Address - Fax:517-592-3959
Is Sole Proprietor?:No
Enumeration Date:2022-11-17
Last Update Date:2024-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5601011458363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant