Provider Demographics
NPI:1184467581
Name:YOUNG, LOGAN ELIZABETH (RN)
Entity type:Individual
Prefix:
First Name:LOGAN
Middle Name:ELIZABETH
Last Name:YOUNG
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 WILDWOOD CT APT 235
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35209-2800
Mailing Address - Country:US
Mailing Address - Phone:864-561-4331
Mailing Address - Fax:
Practice Address - Street 1:100 WILDWOOD CT APT 235
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35209-2800
Practice Address - Country:US
Practice Address - Phone:864-561-4331
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-14
Last Update Date:2024-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC255215163WC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine