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General NPI Number Information
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NPI Number | 1154659431
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Entity Type | Individual
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Provider Name | CHRISTIAN CASEY YOUNG FNP
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Gender | Female
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Dates
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Enumeration Date | 11/25/2009
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Last Update Date | 07/25/2023
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Provider Practice Location Address
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Address Line | 2830 EAST ST
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City | ANDERSON
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State | CA
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Zip | 96007-3408
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Country | US
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Telephone | 530-365-2545
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Fax | 530-365-3871
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Provider Business Mailing Address
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Address Line | PO BOX 1743
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City | SHASTA LAKE
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State | CA
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Zip | 96019-1743
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Country | US
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Telephone | 530-524-6045
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 660294
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 95010353
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License Number State | CA
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