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General NPI Number Information
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NPI Number | 1265082630
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Entity Type | Individual
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Provider Name | JOANNA MARIE YOUNG MSN, APRN, AGACNP-BC
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Gender | Female
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Dates
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Enumeration Date | 09/17/2019
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Last Update Date | 09/17/2019
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Provider Practice Location Address
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Address Line | 1 MEDICAL CENTER DR
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City | LEBANON
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State | NH
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Zip | 03756-1000
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Country | US
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Telephone | 603-650-4211
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Fax |
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Provider Business Mailing Address
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Address Line | 13315 OCEAN MIST DR
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City | JACKSONVILLE
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State | FL
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Zip | 32258-5205
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Country | US
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Telephone | 904-252-1484
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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 | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | 081381-23
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License Number State | NH
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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 | 081381-23
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License Number State | NH
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | APRN11002758
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License Number State | FL
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