Provider Demographics
NPI:1679197875
Name:YOUNG, DAVID LEE (DNP/FNP)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:LEE
Last Name:YOUNG
Suffix:
Gender:M
Credentials:DNP/FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:346 SOUTHWINDS RD
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON
Mailing Address - State:AR
Mailing Address - Zip Code:72730-8648
Mailing Address - Country:US
Mailing Address - Phone:501-463-0665
Mailing Address - Fax:
Practice Address - Street 1:1955 W TRUCKERS DR
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:AR
Practice Address - Zip Code:72704-5637
Practice Address - Country:US
Practice Address - Phone:479-973-6000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-03
Last Update Date:2020-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARXXX363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily