Provider Demographics
NPI:1245521293
Name:YOUNG, LAUREN BRADLEY (NP-C)
Entity type:Individual
Prefix:MRS
First Name:LAUREN
Middle Name:BRADLEY
Last Name:YOUNG
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:MRS
Other - First Name:LAUREN
Other - Middle Name:HOUSTON
Other - Last Name:BRADLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2740 INDIAN OAK DR
Mailing Address - Street 2:
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75071-8234
Mailing Address - Country:US
Mailing Address - Phone:843-814-0196
Mailing Address - Fax:
Practice Address - Street 1:1213 E TRINITY MILLS RD
Practice Address - Street 2:
Practice Address - City:CARROLLTON
Practice Address - State:TX
Practice Address - Zip Code:75006-1446
Practice Address - Country:US
Practice Address - Phone:469-557-7390
Practice Address - Fax:972-396-5173
Is Sole Proprietor?:No
Enumeration Date:2011-04-26
Last Update Date:2014-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX833957363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily