1720052343 NPI number — CAROLYN MARIE VEGLIA YOUNG CPNP

Table of content: CAROLYN MARIE VEGLIA YOUNG CPNP (NPI 1720052343)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1720052343 NPI number — CAROLYN MARIE VEGLIA YOUNG CPNP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
VEGLIA YOUNG
Provider First Name:
CAROLYN
Provider Middle Name:
MARIE
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
CPNP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
YOUNG
Provider Other First Name:
CAROLYN
Provider Other Middle Name:
MARIE
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
CPNP
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1720052343
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/15/2026
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2525 CHICAGO AVENUE SOUTH
Provider Second Line Business Mailing Address:
CHILDREN'S HOSPITALS AND CLINIC OF MINNESOTA
Provider Business Mailing Address City Name:
MINNEAPOLIS
Provider Business Mailing Address State Name:
MN
Provider Business Mailing Address Postal Code:
55404
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
612-813-6117
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
360 COLBORNE ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SAINT PAUL
Provider Business Practice Location Address State Name:
MN
Provider Business Practice Location Address Postal Code:
55102-3228
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
651-767-8189
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/13/2006

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: 363LP0200X , with the licence number:  R 142851-3 , registered in the state of MN ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 163WP0200X , with the licence number: R1428513 , registered in the state of MN ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363LS0200X , with the licence number: 2778 , registered in the state of MN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 901453500 , issued by the state of ( MN ) . This identifiers is of the category "MEDICAID".




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