Provider Demographics
NPI:1003028820
Name:YOUNG, TAMMY NEZ (RD)
Entity Type:Individual
Prefix:MRS
First Name:TAMMY
Middle Name:NEZ
Last Name:YOUNG
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
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Mailing Address - Street 1:6311 WELLS CIR
Mailing Address - Street 2:
Mailing Address - City:SPRINGDALE
Mailing Address - State:AR
Mailing Address - Zip Code:72762-6047
Mailing Address - Country:US
Mailing Address - Phone:479-725-3043
Mailing Address - Fax:479-725-3098
Practice Address - Street 1:4001 WAGON WHEEL RD
Practice Address - Street 2:
Practice Address - City:SPRINGDALE
Practice Address - State:AR
Practice Address - Zip Code:72762-0137
Practice Address - Country:US
Practice Address - Phone:479-725-3043
Practice Address - Fax:479-725-3098
Is Sole Proprietor?:No
Enumeration Date:2007-05-04
Last Update Date:2022-08-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AR266133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR723812OtherTAMMY YOUNG, NATIONAL REG
AR266OtherTAMMY YOUNG, RD