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General NPI Number Information
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NPI Number | 1588693899
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Entity Type | Individual
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Provider Name | STEPHANIE ANNE YOUNG NP
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Gender | Female
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Dates
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Enumeration Date | 06/30/2006
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Last Update Date | 09/06/2012
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Provider Practice Location Address
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Address Line | 800 KINGS HWY N SUITE 203
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City | CHERRY HILL
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State | NJ
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Zip | 08034-1511
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Country | US
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Telephone | 856-348-1143
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Fax |
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Provider Business Mailing Address
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Address Line | 20000 HORIZON WAY SUITE 150
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City | MOUNT LAUREL
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State | NJ
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Zip | 08054-4303
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Country | US
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Telephone | 602-370-0343
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 26NJO08465300
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License Number State | NJ
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