Provider Demographics
NPI:1104078773
Name:YOUNG, ALYSON (NP)
Entity type:Individual
Prefix:
First Name:ALYSON
Middle Name:
Last Name:YOUNG
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8289 E LOWRY BLVD
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80230-7256
Mailing Address - Country:US
Mailing Address - Phone:303-321-2828
Mailing Address - Fax:303-321-7171
Practice Address - Street 1:8289 E LOWRY BLVD
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80230-7256
Practice Address - Country:US
Practice Address - Phone:303-321-2828
Practice Address - Fax:303-321-7171
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-15
Last Update Date:2021-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO169389363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health