Provider Demographics
NPI:1366877367
Name:YOUNG, PATRICIA (CNM, RN)
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:
Last Name:YOUNG
Suffix:
Gender:F
Credentials:CNM, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3730 RHONE CIR
Mailing Address - Street 2:SUITE 101
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99508-5051
Mailing Address - Country:US
Mailing Address - Phone:907-561-5152
Mailing Address - Fax:
Practice Address - Street 1:3730 RHONE CIR
Practice Address - Street 2:SUITE 101
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99508-5051
Practice Address - Country:US
Practice Address - Phone:907-561-5152
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-09-09
Last Update Date:2013-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK1387367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife