Individual
MARYISSA EILEEN YOUNG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1205 S MISSION ST STE 4, MT PLEASANT, MI 48858-3939
(989) 400-4369
Mailing address
3487 S LINDEN RD, FLINT, MI 48507-3025
(866) 498-3909
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
4704315186
MI
363LP0200X
Pediatric Nurse Practitioner
Primary
4704315186
MI
Other
Enumeration date
02/15/2024
Last updated
09/24/2024
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