Individual
WANDA RENEE YOUNG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AGPCNP
Contact information
Practice address
3295 FM 3514, BEAUMONT, TX 77705-7655
(409) 727-8400
Mailing address
10901 TELEPHONE RD APT 44, HOUSTON, TX 77075-4646
(832) 409-9771
(713) 987-5454
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
544145
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00000000
NONE
—
Enumeration date
09/18/2017
Last updated
09/18/2017
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