=====================================================
General NPI Number Information
=====================================================
NPI Number | 1295395150
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | DAWN CLARK YOUNG FNP-C
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/13/2019
-----------------------------------------------------
Last Update Date | 08/11/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 4413 WICHERS DR
-----------------------------------------------------
City | MARRERO
-----------------------------------------------------
State | LA
-----------------------------------------------------
Zip | 70072-3137
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 504-383-0915
-----------------------------------------------------
Fax | 504-383-0948
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 146 GREEN TRAILS DR
-----------------------------------------------------
City | BELLE CHASSE
-----------------------------------------------------
State | LA
-----------------------------------------------------
Zip | 70037-1682
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 504-377-1208
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LF0000X
-----------------------------------------------------
Taxonomy Name | Family Nurse Practitioner
-----------------------------------------------------
License Number | 207040
-----------------------------------------------------
License Number State | LA
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 363LP0808X
-----------------------------------------------------
Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
-----------------------------------------------------
License Number | 207040
-----------------------------------------------------
License Number State | LA
-----------------------------------------------------