Provider Demographics
NPI:1740015023
Name:YOUNG, DESIREE C (FNP-C)
Entity type:Individual
Prefix:
First Name:DESIREE
Middle Name:C
Last Name:YOUNG
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:DESIREE
Other - Middle Name:C
Other - Last Name:DUPREE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:324 N QUEEN ST
Mailing Address - Street 2:
Mailing Address - City:KINSTON
Mailing Address - State:NC
Mailing Address - Zip Code:28501-4932
Mailing Address - Country:US
Mailing Address - Phone:252-522-9800
Mailing Address - Fax:
Practice Address - Street 1:324 N QUEEN ST
Practice Address - Street 2:
Practice Address - City:KINSTON
Practice Address - State:NC
Practice Address - Zip Code:28501-4932
Practice Address - Country:US
Practice Address - Phone:252-522-9800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-05
Last Update Date:2024-12-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCF08240592363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily