Individual
MRS. MIRIAM CHRISTINA YOUNG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
601 E 12TH ST, FLORA, IL 62839-2335
(618) 662-4406
Mailing address
601 E 12TH ST, FLORA, IL 62839-2335
(618) 662-4406
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
041.397461
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
041.397461
STATE LICENSURE
IL
Enumeration date
02/16/2012
Last updated
02/16/2012
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