Provider Demographics
NPI:1184776080
Name:YOUNG, LINDA S (RNP-C)
Entity type:Individual
Prefix:
First Name:LINDA
Middle Name:S
Last Name:YOUNG
Suffix:
Gender:F
Credentials:RNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 BLACKSTONE VALLEY PLACE
Mailing Address - Street 2:BLDG 1, SUITE 100
Mailing Address - City:LINCOLN
Mailing Address - State:RI
Mailing Address - Zip Code:02865-1112
Mailing Address - Country:US
Mailing Address - Phone:401-767-8766
Mailing Address - Fax:866-486-1245
Practice Address - Street 1:6 BLACKSTONE VALLEY PLACE
Practice Address - Street 2:BLDG 1, SUITE 100
Practice Address - City:LINCOLN
Practice Address - State:RI
Practice Address - Zip Code:02865-1112
Practice Address - Country:US
Practice Address - Phone:401-767-8766
Practice Address - Fax:866-486-1245
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-18
Last Update Date:2024-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RINPP37247363L00000X
RIAPRN00306363LA2200X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
411833OtherBCHIP
5496914OtherFIRST HEALTH
27900-2OtherBCBS
RILV50792Medicaid
Q02807Medicare UPIN
5496914OtherFIRST HEALTH
RILV50792Medicaid