Provider Demographics
NPI:1033767504
Name:YOUNG, KATE ELIZABETH (FNP)
Entity Type:Individual
Prefix:
First Name:KATE
Middle Name:ELIZABETH
Last Name:YOUNG
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2205 S BRIDGE ST STE 300
Mailing Address - Street 2:
Mailing Address - City:BRADY
Mailing Address - State:TX
Mailing Address - Zip Code:76825-7552
Mailing Address - Country:US
Mailing Address - Phone:325-597-0102
Mailing Address - Fax:325-597-2939
Practice Address - Street 1:2626 N BRYANT BLVD
Practice Address - Street 2:
Practice Address - City:SAN ANGELO
Practice Address - State:TX
Practice Address - Zip Code:76903-2861
Practice Address - Country:US
Practice Address - Phone:325-747-2104
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-28
Last Update Date:2023-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP142203363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily