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Individual

BRIAN CLAY YOUNG

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
NURSE PRACTITIONER

Contact information

Practice address
638 LEE ROAD 483, OPELIKA, AL 36804-1773
(770) 547-3632
Mailing address
7351 OLD MOON RD, COLUMBUS, GA 31909-7291
(706) 653-7000
(706) 653-7800

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
RN158039
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
RN158039
STATE LICENSE
GA
Enumeration date
08/14/2019
Last updated
09/30/2019
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