Provider Demographics
NPI:1598737488
Name:YOUNG, LAUREN H (NP)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:H
Last Name:YOUNG
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:442 DALEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:BASSETT
Mailing Address - State:VA
Mailing Address - Zip Code:24055-5341
Mailing Address - Country:US
Mailing Address - Phone:276-627-0717
Mailing Address - Fax:
Practice Address - Street 1:2871 GREENSBORO RD
Practice Address - Street 2:
Practice Address - City:MARTINSVILLE
Practice Address - State:VA
Practice Address - Zip Code:24112-8108
Practice Address - Country:US
Practice Address - Phone:276-638-2273
Practice Address - Fax:276-638-2250
Is Sole Proprietor?:No
Enumeration Date:2006-02-03
Last Update Date:2022-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0001086286163W00000X
VA0024086286363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA7782659Medicaid
VA500000235Medicare PIN
VA7782659Medicaid
500000235Medicare PIN
500000235Medicare ID - Type Unspecified