Provider Demographics
NPI:1235506569
Name:YOUNG, JAMIE (FNP-C)
Entity Type:Individual
Prefix:
First Name:JAMIE
Middle Name:
Last Name:YOUNG
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4901 DAWN DR
Mailing Address - Street 2:SUITE 2300
Mailing Address - City:LUMBERTON
Mailing Address - State:NC
Mailing Address - Zip Code:28360-8287
Mailing Address - Country:US
Mailing Address - Phone:910-738-1065
Mailing Address - Fax:
Practice Address - Street 1:4901 DAWN DR
Practice Address - Street 2:SUITE 2300
Practice Address - City:LUMBERTON
Practice Address - State:NC
Practice Address - Zip Code:28360-8287
Practice Address - Country:US
Practice Address - Phone:910-738-1065
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-08-21
Last Update Date:2015-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5007882363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily