Individual
ANGELA YOUNG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
4646 JOHN R ST, DETROIT, MI 48201-1916
(404) 376-3547
Mailing address
4646 JOHN R ST, DETROIT, MI 48201-1916
(313) 576-1000
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
4704259636
MI
363LA2100X
Acute Care Nurse Practitioner
4704259636
MI
363LA2200X
Adult Health Nurse Practitioner
Primary
4704259636
MI
Other
Enumeration date
09/05/2012
Last updated
05/10/2024
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