Individual
NICOLE R YOUNG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
725 S SHOOP AVE, WAUSEON, OH 43567-1702
(419) 335-0215
(419) 337-5988
Mailing address
11109 PARKVIEW PLAZA DR # 117, FORT WAYNE, IN 46845-1701
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
50.003262
OH
Other
Enumeration date
03/25/2011
Last updated
01/04/2023
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