Provider Demographics
NPI:1710265368
Name:YUNG, KIMBERLY DAWN (APRN, CNP)
Entity Type:Individual
Prefix:DR
First Name:KIMBERLY
Middle Name:DAWN
Last Name:YUNG
Suffix:
Gender:F
Credentials:APRN, CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:307 FIRST AVE NE
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55413
Mailing Address - Country:US
Mailing Address - Phone:612-284-8206
Mailing Address - Fax:
Practice Address - Street 1:15245 BLUEBIRD ST NW
Practice Address - Street 2:
Practice Address - City:ANDOVER
Practice Address - State:MN
Practice Address - Zip Code:55304-3538
Practice Address - Country:US
Practice Address - Phone:763-587-4688
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-08-01
Last Update Date:2024-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNCNP 3614363LF0000X
MN3614363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN500007018Medicare PIN