Provider Demographics
NPI:1164023289
Name:YOUNG-HARPER, GINA LYNETTE (APRN FNP)
Entity Type:Individual
Prefix:
First Name:GINA
Middle Name:LYNETTE
Last Name:YOUNG-HARPER
Suffix:
Gender:F
Credentials:APRN FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:701 COUNTY ROAD 126
Mailing Address - Street 2:
Mailing Address - City:CISCO
Mailing Address - State:TX
Mailing Address - Zip Code:76437-6006
Mailing Address - Country:US
Mailing Address - Phone:254-442-1146
Mailing Address - Fax:
Practice Address - Street 1:701 COUNTY ROAD 126
Practice Address - Street 2:
Practice Address - City:CISCO
Practice Address - State:TX
Practice Address - Zip Code:76437-6006
Practice Address - Country:US
Practice Address - Phone:254-442-1146
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-04
Last Update Date:2020-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1018805363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily