Healthcare Provider Details

I. General information

NPI: 1336189927
Provider Name (Legal Business Name): WENDY YOUNG A.P.N.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/08/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

52579 HIGHWAY 51 SOUTH LALLIE KEMP HOSPITAL
INDEPENDENCE LA
70443
US

IV. Provider business mailing address

10084 RICHARDSON RD
INDEPENDENCE LA
70443-3000
US

V. Phone/Fax

Practice location:
  • Phone: 985-878-9421
  • Fax: 985-878-1431
Mailing address:
  • Phone: 985-878-4210
  • Fax: 985-878-1431

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number03737
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: