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Organization

YOUNG HEALTH & WELLNESS

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DIANE YOUNG FNP (PROVIDER)
(801) 815-2967
Entity
Organization

Contact information

Practice address
3018 E 3300 S, SALT LAKE CITY, UT 84109-2144
(801) 815-2967
Mailing address
6321 S BOXWOOD RD, SALT LAKE CITY, UT 84121-2213
(801) 815-2967

Taxonomy

Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
53036184405
UT
363LF0000X
Family Nurse Practitioner
5303618-4405
UT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1194122788
PROVIDER NPI
UT
01
1366982522
PRACTICE NPI
UT
Enumeration date
03/06/2017
Last updated
08/10/2017
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