Organization
JACQUE DESHAY YOUNG, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JACQUE DESHAY YOUNG ARNP (NURSE PRACTITIONER)
(502) 644-4068
Entity
Organization
Contact information
Practice address
4242 DANNY DR, NEW ALBANY, IN 47150-9363
(502) 644-4068
Mailing address
PO BOX 16353, LOUISVILLE, KY 40256-0353
(502) 644-4068
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
5867P
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1639315443
NPI
—
01
—
1972731032
NPI
KY
Enumeration date
06/29/2009
Last updated
09/09/2009
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