Individual
SHAREDA MICKELLE YOUNG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
3070 REIDVILLE RD, SPARTANBURG, SC 29301-5642
(864) 576-5764
Mailing address
426 JEWELWOOD DR, LYMAN, SC 29365-1351
(864) 331-9851
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
24150
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1194729715
—
SC
Enumeration date
02/02/2021
Last updated
02/02/2021
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