Provider Demographics
NPI:1659588127
Name:YOUNG, DEBRA DENISE (ARNP)
Entity Type:Individual
Prefix:
First Name:DEBRA
Middle Name:DENISE
Last Name:YOUNG
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7720 NW 113TH ST
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73162-2500
Mailing Address - Country:US
Mailing Address - Phone:405-722-5402
Mailing Address - Fax:
Practice Address - Street 1:420 NW 6TH ST
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73102-2805
Practice Address - Country:US
Practice Address - Phone:405-235-6466
Practice Address - Fax:405-235-4766
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-16
Last Update Date:2009-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKR0030943363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health