Provider Demographics
NPI:1023033198
Name:YOUNG, NANCY L (R MR)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:L
Last Name:YOUNG
Suffix:
Gender:F
Credentials:R MR
Other - Prefix:
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Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2910 KERRY FOREST PKWY
Mailing Address - Street 2:SUITE A1-A
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32309-6892
Mailing Address - Country:US
Mailing Address - Phone:850-894-9500
Mailing Address - Fax:850-894-9501
Practice Address - Street 1:2910 KERRY FOREST PKWY
Practice Address - Street 2:SUITE A1-A
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32309-6892
Practice Address - Country:US
Practice Address - Phone:850-894-9500
Practice Address - Fax:850-894-9501
Is Sole Proprietor?:No
Enumeration Date:2006-07-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FL13117247100000X
1567852471M1202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered247100000XTechnologists, Technicians & Other Technical Service ProvidersRadiologic Technologist
Not Answered2471M1202XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistMagnetic Resonance Imaging