Individual
MARY ELLEN YOUNG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
422 VALLEY VIEW DR, POYNETTE, WI 53955-8966
(608) 635-7757
Mailing address
422 VALLEY VIEW DR, POYNETTE, WI 53955-8966
(608) 635-7757
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
151850-030
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
35062400
—
WI
Enumeration date
09/17/2008
Last updated
09/17/2008
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