Provider Demographics
NPI:1548045321
Name:YOUNG, MINDY LEANN
Entity type:Individual
Prefix:
First Name:MINDY
Middle Name:LEANN
Last Name:YOUNG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8670 STATE ROUTE 508
Mailing Address - Street 2:
Mailing Address - City:DE GRAFF
Mailing Address - State:OH
Mailing Address - Zip Code:43318-9695
Mailing Address - Country:US
Mailing Address - Phone:937-935-8919
Mailing Address - Fax:
Practice Address - Street 1:8670 STATE ROUTE 508
Practice Address - Street 2:
Practice Address - City:DE GRAFF
Practice Address - State:OH
Practice Address - Zip Code:43318-9695
Practice Address - Country:US
Practice Address - Phone:937-935-8919
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-29
Last Update Date:2023-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide