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NPI Code Detail

MEDICARE: KEVIN MICHAEL YOUNG DNP

MEDICARE:   KEVIN MICHAEL YOUNG  DNP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363L00000XNurse Practitioner11013675FL

General Provider Information

NPI Number : 1376249029
Entity Type Code : Individual
Provider Name (Legal Business Name) : KEVIN MICHAEL YOUNG DNP
Provider Business Mailing Address
First Line : 541 SHADY PINE WAY APT C
Second Line :
City : GREENACRES
State : FL
Zip : 33415-8904
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 541 SHADY PINE WAY APT C
Second Line :
City : GREENACRES
State : FL
Zip : 33415-8904
Country : US
Telephone Number : 607-221-1934
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/03/2023
Last Update Date : 04/11/2023

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