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NPI Code Detail

MEDICARE: HEIDI LANE YOUNG RN

MEDICARE: HEIDI LANE YOUNG RN
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
1163WP0809XAdult Psychiatric/Mental Health Registered Nurse706469TX

General Provider Information

NPI Number : 1518080696
Entity Type Code : Individual
Provider Name (Legal Business Name) : HEIDI LANE YOUNG RN
Provider Business Mailing Address
First Line : 901 S ERVAY ST
Second Line :
City : DALLAS
State : TX
Zip : 75201-6419
Country : US
Telephone Number : 214-939-3933
Fax Number : 914-653-1962
Provider Business Practice Location Address
First Line : 901 S ERVAY ST
Second Line :
City : DALLAS
State : TX
Zip : 75201-6419
Country : US
Telephone Number : 214-939-3933
Fax Number : 914-653-1962
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/06/2007
Last Update Date : 07/08/2007

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