Provider Demographics
NPI:1225594229
Name:YOUNG, STEPHANIE JOY (BSN, RN, NCSN)
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:JOY
Last Name:YOUNG
Suffix:
Gender:F
Credentials:BSN, RN, NCSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:185 W CEDAR ST
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44307-2400
Mailing Address - Country:US
Mailing Address - Phone:330-543-3990
Mailing Address - Fax:
Practice Address - Street 1:185 W CEDAR ST
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44307-2400
Practice Address - Country:US
Practice Address - Phone:330-543-3990
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-02-14
Last Update Date:2019-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH253972163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool