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NPI Code Detail

MEDICARE: MRS. BETHANY LYNN YOUNG FNP

MEDICARE: MRS. BETHANY LYNN YOUNG FNP
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 PractitionerAPRN.CNP.024529OH

General Provider Information

NPI Number : 1538420898
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. BETHANY LYNN YOUNG FNP
Provider Business Mailing Address
First Line : 5933 E PEA RIDGE RD
Second Line :
City : HUNTINGTON
State : WV
Zip : 25705-2629
Country : US
Telephone Number : 304-736-6262
Fax Number :
Provider Business Practice Location Address
First Line : 7743 COUNTY ROAD 1
Second Line :
City : SOUTH POINT
State : OH
Zip : 45680-7822
Country : US
Telephone Number : 740-894-3287
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/04/2012
Last Update Date : 04/30/2019

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