Provider Demographics
NPI:1881425775
Name:YOUNG, KIMBRELY ARNIESE (FNP-C)
Entity type:Individual
Prefix:MS
First Name:KIMBRELY
Middle Name:ARNIESE
Last Name:YOUNG
Suffix:
Gender:F
Credentials:FNP-C
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 165
Mailing Address - Street 2:
Mailing Address - City:GRAYSON
Mailing Address - State:LA
Mailing Address - Zip Code:71435-0165
Mailing Address - Country:US
Mailing Address - Phone:318-329-4041
Mailing Address - Fax:
Practice Address - Street 1:PO BOX 165
Practice Address - Street 2:
Practice Address - City:GRAYSON
Practice Address - State:LA
Practice Address - Zip Code:71435-0165
Practice Address - Country:US
Practice Address - Phone:318-329-4041
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-12
Last Update Date:2024-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA218131363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily