Individual
PHYLLIS ONELLA YOUNG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
516 E NIZHONI BLVD, GALLUP, NM 87301-5748
(505) 722-1000
Mailing address
23006 POST OAK PARK, SAN ANTONIO, TX 78264-4600
(469) 556-6473
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
880378
TX
Other
Enumeration date
04/01/2021
Last updated
04/11/2024
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