Provider Demographics
NPI:1841954955
Name:YOUNG, NAKIA ALEXIS (CPNP-PC)
Entity type:Individual
Prefix:MS
First Name:NAKIA
Middle Name:ALEXIS
Last Name:YOUNG
Suffix:
Gender:F
Credentials:CPNP-PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:730 CELESTE LN SW
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30331-8606
Mailing Address - Country:US
Mailing Address - Phone:347-679-9334
Mailing Address - Fax:
Practice Address - Street 1:1049 N HOUSTON RD
Practice Address - Street 2:
Practice Address - City:WARNER ROBINS
Practice Address - State:GA
Practice Address - Zip Code:31093-1505
Practice Address - Country:US
Practice Address - Phone:478-922-9001
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-25
Last Update Date:2021-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN246622363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics