Provider Demographics
NPI:1023601739
Name:YOUNG, RACHEL PAIGE (NP)
Entity type:Individual
Prefix:MRS
First Name:RACHEL
Middle Name:PAIGE
Last Name:YOUNG
Suffix:
Gender:F
Credentials:NP
Other - Prefix:MRS
Other - First Name:RACHEL
Other - Middle Name:PAIGE
Other - Last Name:WOOD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:409 SEDGWICK LN
Mailing Address - Street 2:
Mailing Address - City:CLARKSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37043-6384
Mailing Address - Country:US
Mailing Address - Phone:410-980-2917
Mailing Address - Fax:
Practice Address - Street 1:111 PEMBERTON DR
Practice Address - Street 2:
Practice Address - City:ASHLAND CITY
Practice Address - State:TN
Practice Address - Zip Code:37015-1353
Practice Address - Country:US
Practice Address - Phone:731-394-1145
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-12
Last Update Date:2021-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN29040363L00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner