Provider Demographics
NPI:1760991731
Name:YOUNG, SANDRA CATRICE (LVN)
Entity Type:Individual
Prefix:MISS
First Name:SANDRA
Middle Name:CATRICE
Last Name:YOUNG
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5750 N MAJOR DR APT 201
Mailing Address - Street 2:
Mailing Address - City:BEAUMONT
Mailing Address - State:TX
Mailing Address - Zip Code:77713-9025
Mailing Address - Country:US
Mailing Address - Phone:409-937-4800
Mailing Address - Fax:
Practice Address - Street 1:5750 N MAJOR DRIVE # 201
Practice Address - Street 2:
Practice Address - City:BEAUMONT
Practice Address - State:TX
Practice Address - Zip Code:77713-9025
Practice Address - Country:US
Practice Address - Phone:409-937-4800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-09-21
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX192717164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse