Healthcare Provider Details

I. General information

NPI: 1184776080
Provider Name (Legal Business Name): LINDA S YOUNG RNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/18/2007
Last Update Date: 10/28/2024
Certification Date: 10/28/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6 BLACKSTONE VALLEY PLACE BLDG 1, SUITE 100
LINCOLN RI
02865-1112
US

IV. Provider business mailing address

6 BLACKSTONE VALLEY PLACE BLDG 1, SUITE 100
LINCOLN RI
02865-1112
US

V. Phone/Fax

Practice location:
  • Phone: 401-767-8766
  • Fax: 866-486-1245
Mailing address:
  • Phone: 401-767-8766
  • Fax: 866-486-1245

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberNPP37247
License Number StateRI
# 2
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberAPRN00306
License Number StateRI
# 3
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAPRN00306
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: