MEDICARE: ASHLY C YOUNT 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
1	363LF0000X	Family Nurse Practitioner	32402	TN

General Provider Information

NPI Number	:	1639891237
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ASHLY C YOUNT FNP

Provider Business Mailing Address
First Line	:	3815 HIGHWAY 66 S STE 1
Second Line	:
City	:	ROGERSVILLE
State	:	TN
Zip	:	37857-5197
Country	:	US
Telephone Number	:	423-817-3542
Fax Number	:

Provider Business Practice Location Address
First Line	:	3815 HIGHWAY 66 S STE 1
Second Line	:
City	:	ROGERSVILLE
State	:	TN
Zip	:	37857-5197
Country	:	US
Telephone Number	:	423-817-3542
Fax Number	:	423-717-5562

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/12/2022
Last Update Date	:	10/01/2024

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