Individual
SHIRLEY YOUNGBLOOD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
56 HOSPITAL STREET, HIAWASSEE, GA 30546
(706) 896-2289
(706) 896-6007
Mailing address
PO BOX 409, HIAWASSEE, GA 30546-0409
(706) 896-2289
(706) 896-6007
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
RN053003
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
7003727
MEDICAID
NC
Enumeration date
09/21/2006
Last updated
07/08/2007
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