Provider Demographics
NPI:1669268215
Name:YOUNG, KASSIE M (MSN, APRN, FNP-C)
Entity type:Individual
Prefix:
First Name:KASSIE
Middle Name:M
Last Name:YOUNG
Suffix:
Gender:
Credentials:MSN, APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:702 E 330 N
Mailing Address - Street 2:
Mailing Address - City:VINEYARD
Mailing Address - State:UT
Mailing Address - Zip Code:84059-4824
Mailing Address - Country:US
Mailing Address - Phone:801-874-1060
Mailing Address - Fax:
Practice Address - Street 1:702 E 330 N
Practice Address - Street 2:
Practice Address - City:VINEYARD
Practice Address - State:UT
Practice Address - Zip Code:84059-4824
Practice Address - Country:US
Practice Address - Phone:801-874-1060
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-18
Last Update Date:2025-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT14217038-4405363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner