Individual
KELLEY MARIE YOUNG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
12520 CROCKERY CREEK DRIVE, RAVENNA, MI 49451
(231) 853-2954
(231) 853-6089
Mailing address
12520 CROCKERY CREEK DRIVE, P.O. BOX 179, RAVENNA, MI 49451-0179
(231) 853-2954
(231) 853-6089
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
4704210304
MI
Other
Enumeration date
04/10/2008
Last updated
04/10/2008
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