Provider Demographics
NPI:1881682417
Name:YOUNG, PATRICIA (RN APN C)
Entity Type:Individual
Prefix:MS
First Name:PATRICIA
Middle Name:
Last Name:YOUNG
Suffix:
Gender:F
Credentials:RN APN C
Other - Prefix:MRS
Other - First Name:PATRICIA
Other - Middle Name:YOUNG
Other - Last Name:ZEE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:10 FERRO DR
Mailing Address - Street 2:
Mailing Address - City:SEWELL
Mailing Address - State:NJ
Mailing Address - Zip Code:08080-9314
Mailing Address - Country:US
Mailing Address - Phone:856-582-1308
Mailing Address - Fax:609-345-2105
Practice Address - Street 1:2829 ATLANTIC AVE
Practice Address - Street 2:
Practice Address - City:ATLANTIC CITY
Practice Address - State:NJ
Practice Address - Zip Code:08401-6325
Practice Address - Country:US
Practice Address - Phone:609-348-4813
Practice Address - Fax:609-345-2105
Is Sole Proprietor?:No
Enumeration Date:2005-10-07
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NN05637900363L00000X
NJ163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ7875606Medicaid