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NPI Code Detail

MEDICARE: MRS. LATISHA FELICE YOUNG FNP-C

MEDICARE: MRS. LATISHA FELICE YOUNG FNP-C
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
1363LF0000XFamily Nurse Practitioner5023631NC

General Provider Information

NPI Number : 1447114731
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. LATISHA FELICE YOUNG FNP-C
Provider Business Mailing Address
First Line : 413 GAMBIT CIR
Second Line :
City : WAKE FOREST
State : NC
Zip : 27587-6162
Country : US
Telephone Number : 917-499-9485
Fax Number :
Provider Business Practice Location Address
First Line : 2702 FARRELL RD
Second Line :
City : SANFORD
State : NC
Zip : 27330-6505
Country : US
Telephone Number : 917-499-9485
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/11/2025
Last Update Date : 12/11/2025

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