Provider Demographics
NPI:1912208117
Name:YOUNG, OLIVIA S (CNM)
Entity type:Individual
Prefix:
First Name:OLIVIA
Middle Name:S
Last Name:YOUNG
Suffix:
Gender:F
Credentials:CNM
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Mailing Address - Street 1:301 LIPPINCOTT DR STE 410
Mailing Address - Street 2:
Mailing Address - City:MARLTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08053-4197
Mailing Address - Country:US
Mailing Address - Phone:856-355-0340
Mailing Address - Fax:856-355-0330
Practice Address - Street 1:4417 N 6TH ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19140-2319
Practice Address - Country:US
Practice Address - Phone:215-302-3600
Practice Address - Fax:215-329-2369
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-04
Last Update Date:2024-09-04
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Provider Licenses
StateLicense IDTaxonomies
PARN618861163W00000X
NJ25ME00068200176B00000X, 367A00000X
PAMW010530367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
No163W00000XNursing Service ProvidersRegistered Nurse
No176B00000XOther Service ProvidersMidwife