Provider Demographics
NPI:1871779546
Name:YOUNG, GINGER A
Entity type:Individual
Prefix:
First Name:GINGER
Middle Name:A
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 1:10450 COSHOCTON RD
Mailing Address - Street 2:
Mailing Address - City:NEW CONCORD
Mailing Address - State:OH
Mailing Address - Zip Code:43762-9459
Mailing Address - Country:US
Mailing Address - Phone:740-796-6956
Mailing Address - Fax:
Practice Address - Street 1:10450 COSHOCTON RD
Practice Address - Street 2:
Practice Address - City:NEW CONCORD
Practice Address - State:OH
Practice Address - Zip Code:43762-9459
Practice Address - Country:US
Practice Address - Phone:740-796-6956
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-12
Last Update Date:2008-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH400532040906374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide