Provider Demographics
NPI:1578581021
Name:YOUNG, CORINNE REBECCA (FNP-C)
Entity Type:Individual
Prefix:MRS
First Name:CORINNE
Middle Name:REBECCA
Last Name:YOUNG
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:MISS
Other - First Name:CORINNE
Other - Middle Name:REBECCA
Other - Last Name:PRESTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2222 N NEVADA AVE
Mailing Address - Street 2:STE 4004
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80907-6819
Mailing Address - Country:US
Mailing Address - Phone:719-471-7064
Mailing Address - Fax:719-776-5459
Practice Address - Street 1:2222 N NEVADA AVE
Practice Address - Street 2:STE 4004
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80907-6819
Practice Address - Country:US
Practice Address - Phone:719-471-7064
Practice Address - Fax:719-776-5459
Is Sole Proprietor?:No
Enumeration Date:2006-07-17
Last Update Date:2018-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CANPF15727363L00000X
CONP990009363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner