Provider Demographics
NPI:1417972845
Name:YOUNG, KAREN (CRNA)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:YOUNG
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1840
Mailing Address - Street 2:
Mailing Address - City:KAILUA KONA
Mailing Address - State:HI
Mailing Address - Zip Code:96745-1840
Mailing Address - Country:US
Mailing Address - Phone:808-325-6760
Mailing Address - Fax:
Practice Address - Street 1:3420 KUHIO HWY
Practice Address - Street 2:
Practice Address - City:LIHUE
Practice Address - State:HI
Practice Address - Zip Code:96766-1049
Practice Address - Country:US
Practice Address - Phone:808-245-1103
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIAPRN250367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI530180-02Medicaid
HI530180-02Medicaid