Organization
J A YOUNG ANESTHESIA ASSOCIATES, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MELENIE NACHIMSON (CREDENTIALING SPECIALIST)
(405) 775-9350
Entity
Organization
Contact information
Practice address
8121 NATIONAL AVE, SUITE 108, MIDWEST CITY, OK 73110-7530
(405) 732-7905
Mailing address
PO BOX 270126, OKLAHOMA CITY, OK 73137-0126
(405) 775-9350
(405) 775-9360
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
R0022980
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100783950C
—
OK
Enumeration date
08/05/2006
Last updated
06/29/2011
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