Healthcare Provider Details

I. General information

NPI: 1093022857
Provider Name (Legal Business Name): SANDRA YOUNG APRN, FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/31/2010
Last Update Date: 11/08/2021
Certification Date: 11/08/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

981 STATE HIGHWAY 121 STE 1140
ALLEN TX
75013-6148
US

IV. Provider business mailing address

1411 N BECKLEY AVE PAV III STE#268
DALLAS TX
75203-1259
US

V. Phone/Fax

Practice location:
  • Phone: 469-697-5100
  • Fax: 469-697-5105
Mailing address:
  • Phone: 214-947-4400
  • Fax: 214-947-4404

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP119312
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: