Provider Demographics
NPI:1306138524
Name:YOUNGBLOOD, NANCY HOFFMAN (PHD, CRNP)
Entity type:Individual
Prefix:
First Name:NANCY
Middle Name:HOFFMAN
Last Name:YOUNGBLOOD
Suffix:
Gender:F
Credentials:PHD, CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1369 OLD YORK RD
Mailing Address - Street 2:
Mailing Address - City:ABINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:19001
Mailing Address - Country:US
Mailing Address - Phone:215-884-1776
Mailing Address - Fax:
Practice Address - Street 1:1369 OLD YORK RD
Practice Address - Street 2:
Practice Address - City:ABINGTON
Practice Address - State:PA
Practice Address - Zip Code:19001
Practice Address - Country:US
Practice Address - Phone:215-884-1776
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-05-05
Last Update Date:2011-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN256467L101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health