Provider Demographics
NPI:1467866517
Name:YOUNG, ANDREA K (NP-C, FNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:ANDREA
Middle Name:K
Last Name:YOUNG
Suffix:
Gender:F
Credentials:NP-C, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:209 LIPPINCOTT LN
Mailing Address - Street 2:
Mailing Address - City:URBANA
Mailing Address - State:OH
Mailing Address - Zip Code:43078-9802
Mailing Address - Country:US
Mailing Address - Phone:937-599-7058
Mailing Address - Fax:937-599-7048
Practice Address - Street 1:209 LIPPINCOTT LN
Practice Address - Street 2:
Practice Address - City:URBANA
Practice Address - State:OH
Practice Address - Zip Code:43078-9802
Practice Address - Country:US
Practice Address - Phone:937-599-7058
Practice Address - Fax:937-599-7048
Is Sole Proprietor?:No
Enumeration Date:2014-06-17
Last Update Date:2023-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.16033363LF0000X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0105306Medicaid