Individual
MYRA A YOUNG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1328 S YORK ST, MUSKOGEE, OK 74403-7650
(918) 683-0470
(918) 683-0475
Mailing address
PO BOX 751, HULBERT, OK 74441-0751
(918) 772-3390
(918) 772-3638
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
99742
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
99742
OKLAHOMA BOARD OF NURSING
OK
Enumeration date
12/23/2015
Last updated
12/23/2015
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