Doctor Name: | MS. MARIANNE ELIZABETH YOUNGBLOOD |
NPI Number: | 1033502745 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | FNP-C |
License Number: | AP127606 |
Business Practice Address: | 6510 Folsom Dr Beaumont, TX - 777067274 |
Business Phone Number: | 4098326545 |
Business Fax Number: | 4098327494 |
Mailing Address: | 6510 Folsom Dr, BEAUMONT |
State: | TX |
Postal Code: | 777067274 |
Phone Number: | 4098326545 |
Fax Number: | 4098327494 |
NPI Enumeration Date: | 03/05/2015 |
NPI Last Update Date: | 03/05/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | AP127606 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TX |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |