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General NPI Number Information
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NPI Number | 1518260363
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Entity Type | Individual
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Provider Name | ALISA MARIE YOUNGLING BSN, RN
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Gender | Female
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Dates
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Enumeration Date | 12/17/2010
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Last Update Date | 01/23/2025
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Provider Practice Location Address
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Address Line | 12501 S 25TH ST
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City | BELLEVUE
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State | NE
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Zip | 68123-5526
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Country | US
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Telephone | 402-293-4710
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Fax |
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Provider Business Mailing Address
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Address Line | 2905 SHERIDAN RD
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City | BELLEVUE
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State | NE
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Zip | 68123-1993
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Country | US
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Telephone | 402-430-4215
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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 | 163WS0200X
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Taxonomy Name | School Registered Nurse
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License Number | 99904
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License Number State | NE
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