Healthcare Provider Details

I. General information

NPI: 1437279064
Provider Name (Legal Business Name): YAKIMA YOUNG-SHIELDS APN, HSN, PMHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/29/2007
Last Update Date: 07/01/2026
Certification Date: 07/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13030 W THUNDERBIRD RD
EL MIRAGE AZ
85335-3256
US

IV. Provider business mailing address

10001 W BELL RD STE 105
SUN CITY AZ
85351-1283
US

V. Phone/Fax

Practice location:
  • Phone: 623-505-1081
  • Fax: 602-296-0193
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number135549
License Number StateMO
# 2
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberAP10775
License Number StateAZ
# 3
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAP10775
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: