Healthcare Provider Details

I. General information

NPI: 1821965005
Provider Name (Legal Business Name): KYLEANA TREASHAY YOUNG
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/21/2025
Last Update Date: 12/18/2025
Certification Date: 12/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15 SKYLAND INN DR FL 3
ARDEN NC
28704-7714
US

IV. Provider business mailing address

108 HOLLY TREE CIR
HENDERSONVILLE NC
28792-9104
US

V. Phone/Fax

Practice location:
  • Phone: 828-654-5001
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number5023308
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: