Provider Demographics
NPI:1194109009
Name:YOUNG, CHELSEA LEIGH (PA-C)
Entity type:Individual
Prefix:
First Name:CHELSEA
Middle Name:LEIGH
Last Name:YOUNG
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 647
Mailing Address - Street 2:
Mailing Address - City:HOPE MILLS
Mailing Address - State:NC
Mailing Address - Zip Code:28348-0647
Mailing Address - Country:US
Mailing Address - Phone:910-483-7337
Mailing Address - Fax:910-483-0648
Practice Address - Street 1:216 E BROAD ST
Practice Address - Street 2:
Practice Address - City:SAINT PAULS
Practice Address - State:NC
Practice Address - Zip Code:28384-1612
Practice Address - Country:US
Practice Address - Phone:910-241-3136
Practice Address - Fax:910-241-3159
Is Sole Proprietor?:No
Enumeration Date:2015-07-10
Last Update Date:2016-06-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC001005881363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1194109009OtherHEALTHSMART
NC1194109009OtherHUMANA
NCFH4002325OtherFIRST CAROLINA CARE
NC5187858OtherAETNA
NC5721709OtherUNITED HEALTHCARE
NC19EK2OtherBCBS OF NC
NC1194109009Medicaid
NC13444973OtherPHCS/MULTIPLAN
NC1194109009OtherDOCTORS DIRECT
NC1277861OtherCIGNA/GREATWEST
NC297182OtherMEDCOST