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Individual
GRANT THOMAS YOUNG
Active
Individual
GRANT THOMAS YOUNG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
APRN-CNP
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
210343
OK
364SG0600X
Gerontology Clinical Nurse Specialist
210343
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
210343
OKLAHOMA STATE BOARD OF NURSING
OK
Enumeration date
09/23/2022
Last updated
09/23/2022
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