Doctor Name: | MS. LESLIE ELIZABETH GIBSON YOUNG |
NPI Number: | 1194061317 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | FNP-BC, RN |
License Number: | RN2270753 |
Business Practice Address: | 1 Widger Rd Marblehead, MA - 019452146 |
Business Phone Number: | 7816315126 |
Business Fax Number: | |
Mailing Address: | 22 Thompson Ln, LYNN |
State: | MA |
Postal Code: | 019042519 |
Phone Number: | 3392030570 |
Fax Number: | |
NPI Enumeration Date: | 12/15/2012 |
NPI Last Update Date: | 03/16/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | RN2270753 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MA |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |