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NPI Code Detail

MEDICARE: MRS. KRISTINE MARIE YOUNG APRN

MEDICARE: MRS. KRISTINE MARIE YOUNG APRN
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
1363LG0600XGerontology Nurse Practitioner53-81606-071KS
2363LA2100XAcute Care Nurse Practitioner53-81606-071KS

General Provider Information

NPI Number : 1568188522
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. KRISTINE MARIE YOUNG APRN
Provider Business Mailing Address
First Line : 3515 W CENTRAL AVE
Second Line :
City : WICHITA
State : KS
Zip : 67203-4921
Country : US
Telephone Number : 316-755-0144
Fax Number :
Provider Business Practice Location Address
First Line : 3515 W CENTRAL AVE
Second Line :
City : WICHITA
State : KS
Zip : 67203-4921
Country : US
Telephone Number : 316-755-0144
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/12/2022
Last Update Date : 08/12/2025

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