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General NPI Number Information
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NPI Number | 1184467581
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Entity Type | Individual
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Provider Name | LOGAN ELIZABETH YOUNG RN
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Gender | Female
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Dates
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Enumeration Date | 06/14/2024
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Last Update Date | 08/03/2026
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Provider Practice Location Address
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Address Line | 2220 N DRUID HILLS RD NE
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City | ATLANTA
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State | GA
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Zip | 30329-3117
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Country | US
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Telephone | 404-785-6712
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Fax |
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Provider Business Mailing Address
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Address Line | 465 MEMORIAL DR SE UNIT 581
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City | ATLANTA
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State | GA
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Zip | 30312-2281
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Country | US
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Telephone | 864-561-4331
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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 | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 718222
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License Number State | GA
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