Provider Demographics
NPI:1346680535
Name:YOUNG, HOLLY STIEHM (RN, MS, CPNP)
Entity Type:Individual
Prefix:MS
First Name:HOLLY
Middle Name:STIEHM
Last Name:YOUNG
Suffix:
Gender:F
Credentials:RN, MS, CPNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2985 GEORGE BUSBEE PKWY NW
Mailing Address - Street 2:
Mailing Address - City:KENNESAW
Mailing Address - State:GA
Mailing Address - Zip Code:30144-6812
Mailing Address - Country:US
Mailing Address - Phone:404-785-8010
Mailing Address - Fax:
Practice Address - Street 1:2985 GEORGE BUSBEE PKWY NW
Practice Address - Street 2:
Practice Address - City:KENNESAW
Practice Address - State:GA
Practice Address - Zip Code:30144-6812
Practice Address - Country:US
Practice Address - Phone:404-785-8010
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-02
Last Update Date:2013-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN151008363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics