Healthcare Provider Details

I. General information

NPI: 1982533865
Provider Name (Legal Business Name): LISA LAURETTE YOUNG APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/16/2026
Last Update Date: 05/16/2026
Certification Date: 05/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3002 SE 1ST AVE STE 200
OCALA FL
34471-0482
US

IV. Provider business mailing address

1202 SW 17TH ST STE 201
OCALA FL
34471-1283
US

V. Phone/Fax

Practice location:
  • Phone: 352-322-2010
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number11047586
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: