Provider Demographics
NPI:1740625722
Name:YOUNG, PATTI ANN (RN)
Entity type:Individual
Prefix:MS
First Name:PATTI
Middle Name:ANN
Last Name:YOUNG
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MS
Other - First Name:PATTI
Other - Middle Name:ANN
Other - Last Name:HURD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:64 2ND AVE
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12202-1240
Mailing Address - Country:US
Mailing Address - Phone:518-449-5170
Mailing Address - Fax:518-598-0493
Practice Address - Street 1:64 2ND AVE
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12202-1240
Practice Address - Country:US
Practice Address - Phone:518-449-5170
Practice Address - Fax:518-598-0493
Is Sole Proprietor?:No
Enumeration Date:2013-05-06
Last Update Date:2013-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY538345-1163WA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WA0400XNursing Service ProvidersRegistered NurseAddiction (Substance Use Disorder)