Young, Shareda Mickelle
Young, Shareda Mickelle is an individual health care provider with primary practice located at 3070 Reidville Rd , Spartanburg SC 29301-5642. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Adult Health, which is considered as her primary health care specialty. Young, Shareda Mickelle can be contacted via phone (864) 576-5764.Contact Information
Primary practice address
3070 Reidville Rd
Spartanburg SC 29301-5642
Phone: (864) 576-5764
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Adult Health | 363LA2200X | 24150 | South Carolina |
Profile Details
| NPI number | 1407447352 |
|---|---|
| LBN Legal business name | Young, Shareda Mickelle |
| Credentials | Nurse Practitioner (NP) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Feb 2nd, 2021 |
| Last updated | Feb 2nd, 2021 - about 5 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1407447352 | NPPES |
| South Carolina | MEDICAID | 1194729715 |
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