MEDICARE: STACY LYNN YOUNG MSN, APRN, 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
1	363LF0000X	Family Nurse Practitioner	APRN11024636	FL
2	363LF0000X	Family Nurse Practitioner	2015016930	MO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1942682984
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STACY LYNN YOUNG MSN, APRN, FNP-C

Provider Business Mailing Address
First Line	:	25 CANTERBURY WOODS
Second Line	:
City	:	ORMOND BEACH
State	:	FL
Zip	:	32174-2449
Country	:	US
Telephone Number	:	573-552-6866
Fax Number	:

Provider Business Practice Location Address
First Line	:	901 STERTHAUS DR
Second Line	:
City	:	ORMOND BEACH
State	:	FL
Zip	:	32174-5133
Country	:	US
Telephone Number	:	573-552-6866
Fax Number	:

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

Provider Enumeration Date	:	06/26/2015
Last Update Date	:	12/10/2024

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