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General NPI Number Information
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NPI Number | 1679205173
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Entity Type | Individual
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Provider Name | DAKOTA LEE YOUNG FNP-C
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Gender | Male
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Dates
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Enumeration Date | 06/24/2022
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Last Update Date | 11/10/2025
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Provider Practice Location Address
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Address Line | 6801 ROGERS AVE STE 202
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City | FORT SMITH
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State | AR
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Zip | 72903-4067
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Country | US
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Telephone | 479-573-3947
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Fax | 479-478-0548
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Provider Business Mailing Address
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Address Line | 10901 E 48TH ST
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City | TULSA
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State | OK
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Zip | 74146-5830
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Country | US
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Telephone | 918-749-8765
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Fax | 918-392-2155
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 220898
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License Number State | AR
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