Healthcare Provider Details

I. General information

NPI: 1033263223
Provider Name (Legal Business Name): JENNIFER DEE YOUNG-COTT APN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/23/2007
Last Update Date: 12/09/2025
Certification Date: 12/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4435 E CHANDLER BLVD STE 200
PHOENIX AZ
85048-7651
US

IV. Provider business mailing address

4435 E CHANDLER BLVD STE 200
PHOENIX AZ
85048-7651
US

V. Phone/Fax

Practice location:
  • Phone: 917-634-5311
  • Fax:
Mailing address:
  • Phone: 917-634-5311
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAP8233
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number53-84981-011
License Number StateKS
# 3
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number0024182644
License Number StateVA
# 4
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number407734
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: