Provider Demographics
NPI:1962537399
Name:YOUNG, CARA CALLOWAY (PHD, APRN, BC)
Entity type:Individual
Prefix:
First Name:CARA
Middle Name:CALLOWAY
Last Name:YOUNG
Suffix:
Gender:F
Credentials:PHD, APRN, BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600C GODCHAUX HALL
Mailing Address - Street 2:461 21ST AVENUE SOUTH
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37240-0001
Mailing Address - Country:US
Mailing Address - Phone:615-343-0637
Mailing Address - Fax:615-343-5898
Practice Address - Street 1:3801 HILLSBORO RD
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37215-2603
Practice Address - Country:US
Practice Address - Phone:615-385-0622
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-23
Last Update Date:2011-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAPN12519363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
F1106115OtherAANC BOARD CERTIFICATION
TNAPN12519OtherADVANCE PRACTICE LICENSE
F1106115OtherAANC BOARD CERTIFICATION