KELLEY MARIE YOUNG (NPI# 1346413309) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1346413309 |
| Entity Type | Individual |
| Full Name | KELLEY MARIE YOUNG |
| Credential | FNP |
| Practice Address |
12520 Crockery Creek Drive Ravenna MI 49451 |
| Mailing Address |
12520 Crockery Creek Drive P.o. Box 179 Ravenna MI 49451-0179 |
| Practice Telephone | 2318532954 |
| Practice Fax Number | 2318536089 |
| Mailing Telephone | 2318532954 |
| Mailing Fax Number | 2318536089 |
| Enumeration Date | 2008-04-10 |
| Last Update Date | 2008-04-10 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
4704210304 | MI | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669705620 | Kelley Jo Young | Physical Therapist | 2000 Hanson Ave, Clovis, CA 93611-5026 | 2009-09-09 |
| 1710460787 | Kelley Young | Behavior Technician | 55 Dodge Rd, Getzville, NY 14068-1205 | 2018-09-14 |
| 1982731717 | Kelley Lynn Young | Internal Medicine | 4321 Washington St, Suite 4000, Kansas City, MO 64111-5961 | 2007-02-28 |
| Street Address |
12520 CROCKERY CREEK DRIVE |
| City | RAVENNA |
| State | MI |
| Zip Code | 49451 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356740245 | Crockery Creek Elder Care, Inc | Assisted Living Facility | 12291 Crockery Creek Dr., Ravenna, MI 49451 | 2014-08-18 |
| 1114251139 | Alisha Lewise Warner | Nurse's Aide | 155 S. Trent Rd., Ravenna, MI 49451 | 2009-09-23 |
| 1508084310 | Bonnie Jean Pline | Family Medicine | 1042 S. Ravenna Rd., Ravenna, MI 49451 | 2007-04-24 |
| 1083619936 | Timothy L Beechnau | Family Medicine | 12520 Crockery Creek Dr., Ravenna, MI 49451 | 2005-06-16 |
| 1417279407 | Apple Family Medicine, P.l.c. | Clinic/Center | 1042 S Ravenna Rd, Ravenna, MI 49451 | 2010-02-18 |
| 1497928469 | Ravenna Family Practice, P.C. | Family Medicine | 12520 Crockery Creek Dr., Ravenna, MI 49451 | 2008-04-10 |
| 1063455129 | Craig R Cameron Dds Plc | Dentist | 12374 Stafford Street, Ravenna, MI 49451-0204 | 2006-06-14 |
| 1083809917 | Craig Robert Cameron | Dentist | 12374 Stafford Street, Ravenna, MI 49451-0204 | 2007-09-13 |
| 1023287836 | Robert D & Cindy L Douglas | Technician/Technologist | 12412 Stafford, Ravenna, MI 49451-0307 | 2008-02-26 |
| 1164784724 | Nicholas S Beechnau | Family Medicine | 12520 Crockery Creek Dr, Ravenna, MI 49451-5100 | 2012-06-11 |
| Find all providers in zip 49451 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518518919 | Lori A Falat | Nurse Practitioner | 2481 Acorn Ave, Ravenna, OH 44266-7802 | 2019-09-26 |
| 1649836784 | Denise Paulat | Nurse Practitioner | 5222 Newton Falls Rd, Ravenna, OH 44266-9603 | 2019-05-14 |
| 1306360219 | Megan Kathryn Marsh | Nurse Practitioner | 3215 Menough Rd, Ravenna, OH 44266 | 2017-08-01 |
| 1922470731 | Alicia M Medina | Nurse Practitioner | 3540 State Route 59, Ravenna, OH 44266-1352 | 2015-10-21 |
| 1104439553 | Temitope A Adeleke | Nurse Practitioner | 6847 N Chestnut St, Ravenna, OH 44266-3929 | 2020-08-26 |
| 1497379408 | Lauren R Lewis | Nurse Practitioner | 6847 N Chestnut St, Ravenna, OH 44266-3929 | 2020-06-04 |
| 1316425598 | Winfield Windell Such IIi | Nurse Practitioner | 6847 N Chestnut St, Ravenna, OH 44266-3929 | 2018-07-31 |
| 1447751664 | Brea E Loewit | Nurse Practitioner | 6847 N Chestnut St, Ravenna, OH 44266-3929 | 2018-02-22 |
| 1558803049 | Kevin Chi Nkeze Shu | Nurse Practitioner | 6847 N Chestnut St, 310, Ravenna, OH 44266-3929 | 2016-11-15 |
| 1386051779 | Thomas R Golden | Nurse Practitioner | 6847 N Chestnut St, Ravenna, OH 44266-3929 | 2014-07-17 |
| Find all providers in RAVENNA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.