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General NPI Number Information
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NPI Number | 1063184083
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Entity Type | Individual
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Provider Name | KAYLA DEANN YOUNG FNP
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Gender | Female
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Dates
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Enumeration Date | 09/28/2021
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Last Update Date | 09/28/2021
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Provider Practice Location Address
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Address Line | 3140 FLORIDA BLVD
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City | BATON ROUGE
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State | LA
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Zip | 70806
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Country | US
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Telephone | 225-650-2000
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Fax |
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Provider Business Mailing Address
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Address Line | 4342 MONTE VISTA DR
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City | ADDIS
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State | LA
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Zip | 70710-3025
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Country | US
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Telephone | 225-776-4237
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number | 218740
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License Number State | LA
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