Provider Demographics
NPI:1144619875
Name:YOUNG, SHELLEY BRIGHT (PA)
Entity Type:Individual
Prefix:
First Name:SHELLEY
Middle Name:BRIGHT
Last Name:YOUNG
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
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Mailing Address - Street 1:PO BOX 1705
Mailing Address - Street 2:
Mailing Address - City:AUGUSTA
Mailing Address - State:GA
Mailing Address - Zip Code:30903-1705
Mailing Address - Country:US
Mailing Address - Phone:706-854-6917
Mailing Address - Fax:706-774-7230
Practice Address - Street 1:818 SAINT SEBASTIAN WAY STE 104
Practice Address - Street 2:
Practice Address - City:AUGUSTA
Practice Address - State:GA
Practice Address - Zip Code:30901-2652
Practice Address - Country:US
Practice Address - Phone:706-434-0130
Practice Address - Fax:706-434-0131
Is Sole Proprietor?:No
Enumeration Date:2015-01-19
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA007294363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant