Provider Demographics
NPI:1851773352
Name:YOUNG, MARJORIE H (FNP)
Entity Type:Individual
Prefix:DR
First Name:MARJORIE
Middle Name:H
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 1:132 DOBBINS HOLLOW RD
Mailing Address - Street 2:
Mailing Address - City:PILOT
Mailing Address - State:VA
Mailing Address - Zip Code:24138-1630
Mailing Address - Country:US
Mailing Address - Phone:540-382-0178
Mailing Address - Fax:
Practice Address - Street 1:132 DOBBINS HOLLOW RD
Practice Address - Street 2:
Practice Address - City:PILOT
Practice Address - State:VA
Practice Address - Zip Code:24138-1630
Practice Address - Country:US
Practice Address - Phone:540-382-0178
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-22
Last Update Date:2015-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0001097506363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily