Provider Demographics
NPI:1437471141
Name:YOUNG, KRISTOPHER THOMAS (FNP-BC)
Entity Type:Individual
Prefix:MR
First Name:KRISTOPHER
Middle Name:THOMAS
Last Name:YOUNG
Suffix:
Gender:M
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:51 W 3RD ST STE 500
Mailing Address - Street 2:
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85281-2871
Mailing Address - Country:US
Mailing Address - Phone:480-237-5098
Mailing Address - Fax:
Practice Address - Street 1:51 W 3RD ST STE 500
Practice Address - Street 2:
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85281-2871
Practice Address - Country:US
Practice Address - Phone:480-237-5098
Practice Address - Fax:877-358-8109
Is Sole Proprietor?:No
Enumeration Date:2010-02-22
Last Update Date:2019-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAP3578363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily