# INNOVATIVE WOMEN'S HEALTHCARE, PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1104535335
- **Authorized official:** MRS. TAMARA KAYE YOUNG CNM, PMHNP-BC (OWNER/MANAGER)
- **Authorized official phone:** (618) 444-5475

## Contact information

- **Practice address:** 2016 VADALABENE DR STE D, MARYVILLE, IL 62062-6901
- **Practice address phone:** (618) 444-5475
- **Mailing address:** 1087 IL ROUTE 127, GREENVILLE, IL 62246-3041
- **Mailing address phone:** (618) 444-5475

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM1300X | Multi-Specialty Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 11/16/2022
- **Last updated:** 11/16/2022