Individual
MRS. MICKEY JEAN YOUNG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
1036 SHEFFIELD PL, ALTON, IL 62002-7574
(618) 567-1104
Mailing address
1036 SHEFFIELD PL, ALTON, IL 62002-7574
(618) 466-1407
Taxonomy
Speciality
Code
Description
License number
State
163WE0900X
Enterostomal Therapy Registered Nurse
041185157
IL
163WE0900X
Enterostomal Therapy Registered Nurse
Primary
092255
MO
Other
Enumeration date
01/30/2009
Last updated
01/30/2009
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