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General NPI Number Information
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NPI Number | 1972855724
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Entity Type | Individual
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Provider Name | MARY BETH YOUNG FNP
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Gender | Female
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Dates
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Enumeration Date | 10/03/2012
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Last Update Date | 05/06/2025
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Provider Practice Location Address
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Address Line | 926 MAIN ST
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City | NASHVILLE
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State | TN
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Zip | 37206-3614
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Country | US
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Telephone | 615-436-9060
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Fax |
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Provider Business Mailing Address
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Address Line | 31 EZEKIAL DR
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City | JACKSON
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State | TN
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Zip | 38305-7415
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Country | US
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Telephone | 731-358-2419
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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 | 17057
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License Number State | TN
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