Provider Demographics
NPI:1619936242
Name:YOUNG, KIMBERLY COLLETTE (RNC MSN)
Entity Type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:COLLETTE
Last Name:YOUNG
Suffix:
Gender:F
Credentials:RNC MSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:603 CANTERBURY TRIAL
Mailing Address - Street 2:
Mailing Address - City:MT JULIET
Mailing Address - State:TN
Mailing Address - Zip Code:37122
Mailing Address - Country:US
Mailing Address - Phone:615-758-3170
Mailing Address - Fax:
Practice Address - Street 1:5651 FRIST BLVD
Practice Address - Street 2:STE 201
Practice Address - City:HERMITAGE
Practice Address - State:TN
Practice Address - Zip Code:37076
Practice Address - Country:US
Practice Address - Phone:615-391-0800
Practice Address - Fax:615-391-0431
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TNAPN0000006723363LX0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology