Provider Demographics
NPI:1689349243
Name:YOUNG, LAURA COLLETTE (PMHNP, APRN)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:COLLETTE
Last Name:YOUNG
Suffix:
Gender:F
Credentials:PMHNP, APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 764
Mailing Address - Street 2:
Mailing Address - City:MAMMOTH SPRING
Mailing Address - State:AR
Mailing Address - Zip Code:72554-0764
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:8400 W 110TH ST STE 250
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66210-2461
Practice Address - Country:US
Practice Address - Phone:913-327-7505
Practice Address - Fax:913-327-7054
Is Sole Proprietor?:No
Enumeration Date:2021-08-14
Last Update Date:2023-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR2192322084P0800X
KS13-108974-091363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry