Healthcare Provider Details

I. General information

NPI: 1831987817
Provider Name (Legal Business Name): ROBERT ALAN YOUNG MSN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/29/2025
Last Update Date: 03/31/2026
Certification Date: 03/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8933 AZTEC RD NE
ALBUQUERQUE NM
87111-4603
US

IV. Provider business mailing address

9208 SAN MATEO BLVD NE
ALBUQUERQUE NM
87113-2386
US

V. Phone/Fax

Practice location:
  • Phone: 505-862-2159
  • Fax:
Mailing address:
  • Phone: 505-421-0238
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN-78855
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: