Provider Demographics
NPI:1821580044
Name:YOUNG, CRYSTAL KAY (CRNP-F)
Entity type:Individual
Prefix:
First Name:CRYSTAL
Middle Name:KAY
Last Name:YOUNG
Suffix:
Gender:F
Credentials:CRNP-F
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 105
Mailing Address - Street 2:
Mailing Address - City:KEEDYSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21756-0105
Mailing Address - Country:US
Mailing Address - Phone:301-660-7244
Mailing Address - Fax:
Practice Address - Street 1:1101 WILSON BLVD FL 6
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22209-2281
Practice Address - Country:US
Practice Address - Phone:888-731-8994
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-04
Last Update Date:2024-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024178861363LF0000X
MDR199247363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD309005100Medicaid