Provider Demographics
NPI:1902060882
Name:YOUNG, INEZ (RN, MSN-FNP)
Entity type:Individual
Prefix:
First Name:INEZ
Middle Name:
Last Name:YOUNG
Suffix:
Gender:F
Credentials:RN, MSN-FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2400 S AVENUE A
Mailing Address - Street 2:
Mailing Address - City:YUMA
Mailing Address - State:AZ
Mailing Address - Zip Code:85364-7127
Mailing Address - Country:US
Mailing Address - Phone:928-344-2000
Mailing Address - Fax:
Practice Address - Street 1:11142 S SCOTTSDALE DR
Practice Address - Street 2:
Practice Address - City:YUMA
Practice Address - State:AZ
Practice Address - Zip Code:85367-5616
Practice Address - Country:US
Practice Address - Phone:928-336-1815
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-10
Last Update Date:2024-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN124294363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ368013Medicaid
031824Medicare Oscar/Certification
AZZ124790Medicare PIN
031823Medicare Oscar/Certification
AZZ21116Medicare PIN
AZZ124788Medicare PIN
Z21115Medicare Oscar/Certification
Z21113Medicare Oscar/Certification
AZZ124791Medicare PIN
AZZ124789Medicare PIN
AZ368013Medicaid
Z21114Medicare Oscar/Certification
Z21130Medicare Oscar/Certification
031822Medicare Oscar/Certification
031823Medicare Oscar/Certification