Healthcare Provider Details

I. General information

NPI: 1528067493
Provider Name (Legal Business Name): PATRICIA E YOUNT APRNBC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/21/2005
Last Update Date: 06/17/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1105 W LIBERTY SUITE 2050
FARMINGTON MO
63640
US

IV. Provider business mailing address

1105 W LIBERTY SUITE 2050
FARMINGTON MO
63640
US

V. Phone/Fax

Practice location:
  • Phone: 573-701-9600
  • Fax: 573-701-9605
Mailing address:
  • Phone: 573-701-9600
  • Fax: 573-701-9605

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number120697
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: