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General NPI Number Information
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NPI Number | 1952302747
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Entity Type | Individual
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Provider Name | KATHRYN LOSHARON YOUNG FNPC
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Gender | Female
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Dates
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Enumeration Date | 08/03/2005
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 980 MAIN ST.
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City | FAIRPLAY
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State | CO
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Zip | 80440-0723
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Country | US
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Telephone | 719-836-3455
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Fax | 719-836-1792
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Provider Business Mailing Address
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Address Line | PO BOX 723 980 MAIN ST.
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City | FAIRPLAY
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State | CO
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Zip | 80440-0723
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Country | US
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Telephone | 719-836-3455
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Fax | 719-836-1792
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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 | 43262
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License Number State | CO
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