Healthcare Provider Details

I. General information

NPI: 1083286876
Provider Name (Legal Business Name): TAYLER LYNNE YOUNG
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/12/2021
Last Update Date: 03/14/2023
Certification Date: 03/13/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1101 15TH ST NW
WASHINGTON DC
20005-5002
US

IV. Provider business mailing address

60 MADISON AVE FL 5
NEW YORK NY
10010-1600
US

V. Phone/Fax

Practice location:
  • Phone: 202-798-0100
  • Fax:
Mailing address:
  • Phone: 212-545-2400
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberF347852-01
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberNP500005635
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: