Healthcare Provider Details

I. General information

NPI: 1700743457
Provider Name (Legal Business Name): ROXANNE ALEXA YOUNG RN
Entity Type: Individual
Gender:
Sole Proprietor: Y

Provider Other Name: ROXANNE A YOUNG RN

II. Dates (important events)

Enumeration Date: 01/06/2026
Last Update Date: 01/06/2026
Certification Date: 01/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6840 3RD ST
JUPITER FL
33458-3878
US

IV. Provider business mailing address

6840 3RD ST
JUPITER FL
33458-3878
US

V. Phone/Fax

Practice location:
  • Phone: 561-339-7995
  • Fax:
Mailing address:
  • Phone: 561-339-7995
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC0400X
TaxonomyCase Management Registered Nurse
License NumberRN9366737
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: