Provider Demographics
NPI:1083239545
Name:YOUNG, JOHANNA C (PA-C)
Entity type:Individual
Prefix:
First Name:JOHANNA
Middle Name:C
Last Name:YOUNG
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Gender:
Credentials:PA-C
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Mailing Address - Street 1:6701 CARMEL RD STE 116
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28226-3953
Mailing Address - Country:US
Mailing Address - Phone:980-327-1010
Mailing Address - Fax:980-646-0700
Practice Address - Street 1:103 MCALPINE LN # A
Practice Address - Street 2:
Practice Address - City:LAURINBURG
Practice Address - State:NC
Practice Address - Zip Code:28352-4637
Practice Address - Country:US
Practice Address - Phone:910-277-7546
Practice Address - Fax:910-277-0048
Is Sole Proprietor?:No
Enumeration Date:2020-06-10
Last Update Date:2025-03-31
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Provider Licenses
StateLicense IDTaxonomies
NC0010-10212363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant