Individual
YOUNGER FASUEKOI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
HHA/LNA
Contact information
Practice address
5190 N 55TH AVE APT 250, GLENDALE, AZ 85301-7543
(763) 283-7679
Mailing address
5190 N 55TH AVE APT 250, GLENDALE, AZ 85301-7543
(763) 283-7679
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
249313
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
20201227124613
—
AZ
Enumeration date
01/20/2021
Last updated
01/20/2021
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