Individual
NICOLE J. YOUNG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
3341 BEALE AVE, ALTOONA, PA 16601-1549
(814) 944-5357
(814) 946-8017
Mailing address
3341 BEALE AVE, ALTOONA, PA 16601-1549
(814) 944-5357
(814) 946-8017
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
MA055624
PA
363AM0700X
Medical Physician Assistant
TMA052664
PA
363AS0400X
Surgical Physician Assistant
TMA052664
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MA055624
PA STATE LICENSE
PA
01
—
TMA052664
TEMPORARY STATE LICENSE
PA
Enumeration date
06/27/2012
Last updated
03/03/2025
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