Provider Demographics
NPI:1972932051
Name:YOUNG, ELIZABETH ANN (FNP-C)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:ANN
Last Name:YOUNG
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:123 SANTA ANNA AVE
Mailing Address - Street 2:
Mailing Address - City:COLEMAN
Mailing Address - State:TX
Mailing Address - Zip Code:76834-7409
Mailing Address - Country:US
Mailing Address - Phone:325-625-9000
Mailing Address - Fax:325-625-9010
Practice Address - Street 1:123 SANTA ANNA AVE
Practice Address - Street 2:
Practice Address - City:COLEMAN
Practice Address - State:TX
Practice Address - Zip Code:76834-7409
Practice Address - Country:US
Practice Address - Phone:325-625-9000
Practice Address - Fax:325-625-9010
Is Sole Proprietor?:No
Enumeration Date:2013-11-08
Last Update Date:2021-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX785855363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner