Provider Demographics
NPI:1689008369
Name:YOUNG, RACHAEL LYNN (FNP)
Entity Type:Individual
Prefix:
First Name:RACHAEL
Middle Name:LYNN
Last Name:YOUNG
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 DOCTORS DR STE F
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28546-6308
Mailing Address - Country:US
Mailing Address - Phone:910-353-1499
Mailing Address - Fax:910-355-0404
Practice Address - Street 1:200 DOCTORS DR STE F
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28546-6308
Practice Address - Country:US
Practice Address - Phone:910-353-1499
Practice Address - Fax:910-355-0404
Is Sole Proprietor?:No
Enumeration Date:2013-08-29
Last Update Date:2023-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5011763363LF0000X
NC238879363LF0000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily