Provider Demographics
NPI:1083257448
Name:YOUNG, KRISTEN FAITH
Entity Type:Individual
Prefix:
First Name:KRISTEN
Middle Name:FAITH
Last Name:YOUNG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:KRISTEN
Other - Middle Name:FAITH
Other - Last Name:HERRING
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2709 PROSPERITY
Mailing Address - Street 2:
Mailing Address - City:LEANDER
Mailing Address - State:TX
Mailing Address - Zip Code:78641-8693
Mailing Address - Country:US
Mailing Address - Phone:559-308-5445
Mailing Address - Fax:
Practice Address - Street 1:801 E WHITESTONE BLVD STE 201
Practice Address - Street 2:
Practice Address - City:CEDAR PARK
Practice Address - State:TX
Practice Address - Zip Code:78613-7559
Practice Address - Country:US
Practice Address - Phone:512-341-0900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-17
Last Update Date:2019-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP143597363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care