1528199296 NPI number — SHARON L YOUNG NP

Table of content: SHARON L YOUNG NP (NPI 1528199296)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1528199296 NPI number — SHARON L YOUNG NP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
YOUNG
Provider First Name:
SHARON
Provider Middle Name:
L
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
NP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1528199296
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/15/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
203 S. CANDY LANE
Provider Second Line Business Mailing Address:
SUSAN ALBRIGHT RNP, PLLC SUITE 4-A
Provider Business Mailing Address City Name:
COTTONWOOD
Provider Business Mailing Address State Name:
AZ
Provider Business Mailing Address Postal Code:
86326-0000
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
928-649-1389
Provider Business Mailing Address Fax Number:
928-634-5314

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
203 S CANDY LN
Provider Second Line Business Practice Location Address:
SUITE 4-A
Provider Business Practice Location Address City Name:
COTTONWOOD
Provider Business Practice Location Address State Name:
AZ
Provider Business Practice Location Address Postal Code:
86326-4120
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
928-649-1389
Provider Business Practice Location Address Fax Number:
928-634-5314
Provider Enumeration Date:
03/07/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LA2200X , with the licence number:  RN061053 , registered in the state of AZ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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