MARY JEAN YOUNGBLOOD (NPI# 1295141018) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1295141018 |
| Entity Type | Individual |
| Full Name | MARY JEAN YOUNGBLOOD |
| Credential | N.P. |
| Practice Address |
1365 Clifton Rd Ne Suite 2300 Atlanta GA 30322-1013 |
| Practice Telephone | 4047780991 |
| Practice Fax Number | 4047785879 |
| Mailing Telephone | 4047780991 |
| Mailing Fax Number | 4047785879 |
| Enumeration Date | 2014-07-02 |
| Last Update Date | 2014-07-02 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
F0114691 | GA | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | MEDICARE | 1396798229 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720537699 | Mary Youngblood | Registered Nurse | 7210 S 27th Way, Phoenix, AZ 85042 | 2016-10-03 |
| 1477749109 | Mary Ellen Youngblood | Counselor | 403 N Broad St, Adrian, MI 49221-2127 | 2007-09-17 |
| 1376734731 | Mary Katherine Youngblood | Internal Medicine | 1301 2nd Ave Sw, Largo, FL 33770-3120 | 2007-08-09 |
| Street Address |
1365 CLIFTON RD NE SUITE 2300 |
| City | ATLANTA |
| State | GA |
| Zip Code | 30322-1013 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124022637 | Richard Duszak Jr. | Radiology | 1365 Clifton Rd Ne, Emory University Department of Radiology, Atlanta, GA 30322-1013 | 2005-06-13 |
| 1891319091 | Kayla Sondria Freeman | Registered Nurse | 1365 Clifton Rd Ne, Atlanta, GA 30322-1013 | 2020-06-03 |
| 1548881576 | Rachelle Leona Rouse | Student in an Organized Health Care Education/Training Program | 1365 Clifton Rd Ne, Atlanta, GA 30322-1013 | 2020-04-30 |
| 1982233227 | Kayla Anne Nichols | Pharmacist | 1365 Clifton Rd Ne, Atlanta, GA 30322-1013 | 2020-04-08 |
| 1326675380 | Tankeia Tanye' Warren | Nurse Practitioner | 1365 Clifton Rd Ne, Atlanta, GA 30322-1013 | 2020-03-26 |
| 1407488687 | Bethany Joan Hanscom | Physician Assistant | 1365 Clifton Rd Ne, Atlanta, GA 30322-1013 | 2020-02-06 |
| 1518505577 | Juanjuan Wu | Nurse Practitioner | 1365 Clifton Rd Ne, Atlanta, GA 30322-1013 | 2019-12-20 |
| 1942847587 | Nour Majed Moukalled | Internal Medicine | 1365 Clifton Rd Ne, Atlanta, GA 30322-1013 | 2019-12-02 |
| 1528604816 | Tram Bao Vu | Physician Assistant | 1365 Clifton Rd Ne, Atlanta, GA 30322-1013 | 2019-11-21 |
| 1083266845 | Desiree Morgan Rogers | Nurse Practitioner | 1365 Clifton Rd Ne, Atlanta, GA 30322-1013 | 2019-07-11 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700445830 | Justin Gill | Student in an Organized Health Care Education/Training Program | 1365 Clifton Rd Ne, Clinic B - Suite B6100, Atlanta, GA 30322 | 2019-06-12 |
| 1891354510 | Gwendolyn Gisiner Gunn | Genetic Counselor, MS | Emory Genetics Clinic, 1365 Clifton Road Ne, Atlanta, GA 30322 | 2019-06-06 |
| 1144710567 | Lisa Cathy-ann Akosa | Registered Nurse | 1365 Cifton Road Ne, Atlanta, GA 30322 | 2018-05-10 |
| 1083118004 | Jessica Milian Keilson | Student in an Organized Health Care Education/Training Program | 1364 Clifton Road Ne, Suite H100, Emory University Hospital Office of Surgical Education, Atlanta, GA 30322 | 2018-03-23 |
| 1568982684 | Jennifer Bilko | Dietitian, Registered | 1365 Clifton Rd., Bldg A, 1st Floor, Suite 1450, Atlanta, GA 30322 | 2017-06-20 |
| 1134652258 | Kassahun Bilcha | Student in an Organized Health Care Education/Training Program | 1525 Clifton Rd Ne Ste 100, Atlanta, GA 30322 | 2017-04-05 |
| 1356872246 | Tova Rogers | Dermatology | 1525 Clifton Road Suite 105, Atlanta, GA 30322 | 2017-03-23 |
| 1194271445 | Dina Amin | Dentist | 1365 Clifton,building B, Oral and Maxillofacial Surgery, Suite 2300, Atlanta, GA 30322 | 2016-08-28 |
| 1427404904 | Rita Kaur Kuwahara | Student in an Organized Health Care Education/Training Program | 100 Woodruff Circle, Suite 327, Atlanta, GA 30322 | 2016-05-13 |
| 1891176251 | Octav Cristea | Transplant Surgery | 1365 Clifton Road Northeast, Building B, 6th Floor, Atlanta, GA 30322 | 2015-06-11 |
| Find all providers in zip 30322 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144820614 | Nia Charnice Griffin | Nurse Practitioner | 5670 Peachtree Dunwoodyroad, Suite 900, Atlanta, GA 30342 | 2020-10-26 |
| 1790398790 | Starr Patrice Dickerson | Nurse Practitioner | 655 Dot Dr, Atlanta, GA 30349-2730 | 2020-08-28 |
| 1265042162 | Habida Elachola | Nurse Practitioner | 2533 Henderson Mill Rd Ne, Atlanta, GA 30345-2135 | 2020-08-05 |
| 1184249815 | Nichelle Osborne | Nurse Practitioner | 5785 Roswell Rd, Atlanta, GA 30328-4903 | 2020-06-09 |
| 1902427149 | Oasis Health Services, LLC | Nurse Practitioner | 6595 Roswell Rd Ste G1255, Atlanta, GA 30328-3152 | 2020-04-28 |
| 1063042927 | Mary Gillon Hall | Nurse Practitioner | 90 La Rue Pl Nw, Atlanta, GA 30327-4075 | 2020-01-20 |
| 1396382321 | Stacey Brinkley | Nurse Practitioner | 3725 Princeton Lakes Pkwy Sw Apt 7304, Atlanta, GA 30331-5564 | 2019-12-10 |
| 1801439401 | Debadrita Mondal | Nurse Practitioner | 180 Jackson St Ne Apt 2506, Atlanta, GA 30312-1373 | 2019-10-26 |
| 1265075170 | Cecile Veronica Maner | Nurse Practitioner | 105 Collier Rd Nw Ste 3040, Atlanta, GA 30309-1733 | 2019-10-23 |
| 1194366567 | Tondalaya K Sanford | Nurse Practitioner | 3119 Fonseca Pass, Atlanta, GA 30349-8140 | 2019-10-07 |
| Find all providers in ATLANTA | ||||
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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.