Provider Demographics
NPI:1841514155
Name:YOUNG, MARGARET REID (CPNP)
Entity type:Individual
Prefix:
First Name:MARGARET
Middle Name:REID
Last Name:YOUNG
Suffix:
Gender:F
Credentials:CPNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:136 MOUNTAIN PERKINS LANE
Mailing Address - Street 2:SUITE 2
Mailing Address - City:JACKSBORO
Mailing Address - State:TN
Mailing Address - Zip Code:37757
Mailing Address - Country:US
Mailing Address - Phone:423-562-4149
Mailing Address - Fax:423-566-6929
Practice Address - Street 1:136 MOUNTAIN PERKINS LANE
Practice Address - Street 2:SUITE 2
Practice Address - City:JACKSBORO
Practice Address - State:TN
Practice Address - Zip Code:37757
Practice Address - Country:US
Practice Address - Phone:423-562-4149
Practice Address - Fax:423-566-6929
Is Sole Proprietor?:No
Enumeration Date:2010-03-16
Last Update Date:2010-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAPN0000014050363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics