Provider Demographics
NPI:1215579040
Name:YOUNG, EMILY OUTEN (APN)
Entity Type:Individual
Prefix:MRS
First Name:EMILY
Middle Name:OUTEN
Last Name:YOUNG
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:EMILY
Other - Middle Name:
Other - Last Name:OUTEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1025 W MEETING ST SUITE 200
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:SC
Mailing Address - Zip Code:29720-2246
Mailing Address - Country:US
Mailing Address - Phone:803-285-1082
Mailing Address - Fax:803-283-4329
Practice Address - Street 1:1025 W MEETING ST SUITE 200
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:SC
Practice Address - Zip Code:29720-2246
Practice Address - Country:US
Practice Address - Phone:803-285-7414
Practice Address - Fax:803-283-4329
Is Sole Proprietor?:No
Enumeration Date:2019-10-14
Last Update Date:2023-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC23324363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC23324OtherBOARD: NURSING