Most Relevant Information
Provider Data
| NPI Number: | 1003677899 |
| Provider Name: | JORDAN TAYLOR YOUNG PMHNP |
| Entity Type: | Individual |
| Taxonomy Code: | 163WP0808X |
| Specialty: | Registered Nurse |
| License Number: | 798974 |
Most Important Dates
| Enumeration Date: | 01/18/2024 |
| Last Updated: | 10/17/2024 |
Provider Practice Location
4811 BUCKLEY RD
LIVERPOOL
NY
130883676
Practice Location Phone/Fax
| Phone: | 3154579966 |
| Fax: |
Provider Mailing Location
PO BOX 353
HOMER
NY
130770353
Provider Mailing Phone/Fax
| Phone: | 6073450824 |
| Fax: |