Provider Demographics
NPI:1821439241
Name:GHEN, IRENA YOUNG (APRN)
Entity type:Individual
Prefix:
First Name:IRENA
Middle Name:YOUNG
Last Name:GHEN
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1996 SW ENGLISH GARDEN DR
Mailing Address - Street 2:
Mailing Address - City:PALM CITY
Mailing Address - State:FL
Mailing Address - Zip Code:34990-8617
Mailing Address - Country:US
Mailing Address - Phone:772-240-4693
Mailing Address - Fax:856-246-5662
Practice Address - Street 1:1996 SW ENGLISH GARDEN DR
Practice Address - Street 2:
Practice Address - City:PALM CITY
Practice Address - State:FL
Practice Address - Zip Code:34990-8617
Practice Address - Country:US
Practice Address - Phone:772-240-4693
Practice Address - Fax:856-246-5662
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-14
Last Update Date:2024-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9270960363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily