Healthcare Provider Details

I. General information

NPI: 1639235211
Provider Name (Legal Business Name): CHARLOTTE KAREN YOUNG RN, APN,BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/28/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

651 WILLOW GROVE ST
HACKETTSTOWN NJ
07840-1799
US

IV. Provider business mailing address

25 KILLDEER DR
HACKETTSTOWN NJ
07840-3031
US

V. Phone/Fax

Practice location:
  • Phone: 908-441-1127
  • Fax: 908-441-1411
Mailing address:
  • Phone: 908-852-7730
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WE0900X
TaxonomyEnterostomal Therapy Registered Nurse
License NumberNO4523900
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: