Provider Demographics
NPI:1992110043
Name:YOUNG, NICOLE PATRICK (CRNP)
Entity type:Individual
Prefix:MRS
First Name:NICOLE
Middle Name:PATRICK
Last Name:YOUNG
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1855 SPRING HILL AVE
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36607-2301
Mailing Address - Country:US
Mailing Address - Phone:251-471-3544
Mailing Address - Fax:251-476-7456
Practice Address - Street 1:168 MOBILE INFIRMARY BLVD
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36607-3510
Practice Address - Country:US
Practice Address - Phone:251-433-1895
Practice Address - Fax:251-433-1917
Is Sole Proprietor?:No
Enumeration Date:2014-06-27
Last Update Date:2022-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-115256363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner