Healthcare Provider Details

I. General information

NPI: 1043081300
Provider Name (Legal Business Name): MRS. SAVANNAH MORRISON YOUNG
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/15/2024
Last Update Date: 10/09/2026
Certification Date: 10/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

138 EASTBROOKE CT UNIT 115
MT WASHINGTON KY
40047-5570
US

IV. Provider business mailing address

138 EASTBROOKE CT UNIT 115
MT WASHINGTON KY
40047-5570
US

V. Phone/Fax

Practice location:
  • Phone: 502-617-4068
  • Fax: 502-617-4068
Mailing address:
  • Phone: 502-617-4068
  • Fax: 502-617-4068

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number4061553
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: