Healthcare Provider Details

I. General information

NPI: 1922916204
Provider Name (Legal Business Name): TAMMY JEAN YOUNG NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/28/2026
Last Update Date: 08/28/2026
Certification Date: 08/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

125 E MAXWELL ST
LEXINGTON KY
40508-2678
US

IV. Provider business mailing address

1085 CRIMSON CREEK DR
LEXINGTON KY
40509-2386
US

V. Phone/Fax

Practice location:
  • Phone: 859-323-0005
  • Fax: 859-323-0790
Mailing address:
  • Phone: 859-806-7728
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VM0101X
TaxonomyMaternal & Fetal Medicine Physician
License Number4058910
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: