Provider Demographics
NPI:1700537297
Name:YOUNG, ASHLEY N (LPN)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:N
Last Name:YOUNG
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 45774
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53744-5774
Mailing Address - Country:US
Mailing Address - Phone:608-886-1575
Mailing Address - Fax:
Practice Address - Street 1:5164 ANTON DR APT 314
Practice Address - Street 2:
Practice Address - City:FITCHBURG
Practice Address - State:WI
Practice Address - Zip Code:53719-4220
Practice Address - Country:US
Practice Address - Phone:608-886-1575
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-16
Last Update Date:2022-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI326074164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse