Provider Demographics
NPI:1811594385
Name:YOUNG, CHRISTINE (DNP PMHNP-BC)
Entity Type:Individual
Prefix:DR
First Name:CHRISTINE
Middle Name:
Last Name:YOUNG
Suffix:
Gender:F
Credentials:DNP PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2105 CRUMS LN
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40216-4231
Mailing Address - Country:US
Mailing Address - Phone:502-589-8915
Mailing Address - Fax:
Practice Address - Street 1:2105 CRUMS LN
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40216-4231
Practice Address - Country:US
Practice Address - Phone:502-589-8915
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-07
Last Update Date:2021-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3015013363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health