Healthcare Provider Details

I. General information

NPI: 1578581021
Provider Name (Legal Business Name): CORINNE REBECCA YOUNG FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MISS CORINNE REBECCA PRESTON

II. Dates (important events)

Enumeration Date: 07/17/2006
Last Update Date: 10/01/2024
Certification Date: 10/01/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2312 N NEVADA AVE STE 305
COLORADO SPRINGS CO
80907-5318
US

IV. Provider business mailing address

2312 N NEVADA AVE STE 305
COLORADO SPRINGS CO
80907-5318
US

V. Phone/Fax

Practice location:
  • Phone: 719-471-7064
  • Fax: 719-776-5459
Mailing address:
  • Phone: 719-471-7064
  • Fax: 719-776-5459

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberNPF15727
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberNP990009
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: