Provider Demographics
NPI:1841694320
Name:YOUNG, DENISE
Entity type:Individual
Prefix:MS
First Name:DENISE
Middle Name:
Last Name:YOUNG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5135 CAMINO AL NORTE STE 150
Mailing Address - Street 2:
Mailing Address - City:NORTH LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89031-2388
Mailing Address - Country:US
Mailing Address - Phone:702-853-6714
Mailing Address - Fax:702-853-6715
Practice Address - Street 1:5135 CAMINO AL NORTE STE 150
Practice Address - Street 2:
Practice Address - City:NORTH LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89031
Practice Address - Country:US
Practice Address - Phone:702-853-6714
Practice Address - Fax:702-853-6715
Is Sole Proprietor?:No
Enumeration Date:2014-10-13
Last Update Date:2018-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
NV3747P1801X, 372500000X, 372600000X, 3747A0650X, 376J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No372500000XNursing Service Related ProvidersChore Provider
No372600000XNursing Service Related ProvidersAdult Companion
No3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider
No376J00000XNursing Service Related ProvidersHomemaker