Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LP0808X | Nurse Practitioner - Psychiatric/Mental Health | 3002233 | KY |
NPI | 1033186135 |
---|---|
Provider Name | Ms. Roslyn Young |
First Address | Lexington, KY 40503-1827 |
Second Address | Lexington, KY 40503-1827 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/03/2006 |
Last Update Date | 20/11/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000000391954 | BCBS CKBH (01) | |
30615058 | (05) | KY |
78011103 | (05) | KY |
S39854 | (02) | KY |