Doctor Name: | REGINA M YOUNG |
NPI Number: | 1124298849 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | N.P. |
License Number: | R803797 |
Business Practice Address: | 601 Foote St Corinth, MS - 388344834 |
Business Phone Number: | 6622874424 |
Business Fax Number: | 6622872070 |
Mailing Address: | Po Box 839, CORINTH |
State: | MS |
Postal Code: | 388350839 |
Phone Number: | 6622869883 |
Fax Number: | 6622849836 |
NPI Enumeration Date: | 03/10/2008 |
NPI Last Update Date: | 02/15/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LG0600X |
License Number: | R803797 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MS |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Gerontology |
Taxonomy Definition: |