Provider Demographics
NPI:1831987817
Name:YOUNG, ROBERT ALAN (MSN)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:ALAN
Last Name:YOUNG
Suffix:
Gender:M
Credentials:MSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8933 AZTEC RD NE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87111-4603
Mailing Address - Country:US
Mailing Address - Phone:505-862-2159
Mailing Address - Fax:
Practice Address - Street 1:8933 AZTEC RD NE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87111-4603
Practice Address - Country:US
Practice Address - Phone:505-862-2159
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-29
Last Update Date:2025-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMRN-78855163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse