Individual
SHANNON R YOUNG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
404 STEVE DRIVE, RUSSELL SPRINGS, KY 42642-4622
(270) 866-3161
(270) 866-3163
Mailing address
PO BOX 1080, BURKESVILLE, KY 42717-1080
(270) 864-1472
(270) 864-1693
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
3007710
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3007710
KY APRN LICENSE
KY
05
—
7100242840
—
KY
Enumeration date
10/15/2012
Last updated
07/03/2023
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