| NPI | 1619748779 | 
|---|---|
| Former Name | MICHELLE ELAINE YOUNG | 
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 4008833)  | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: KY KY46199)  | 
| 207R00000X Internal Medicine (Licence: KY KY45185)  | |
| Enumeration Date | 2024-01-09 | 
| Last Update Date | 2024-05-23 |