Individual
KELLY M YOUNG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, CNP
Contact information
Practice address
1009 RIDGEWAY PL, FARMINGTON, NM 87401-2092
(505) 327-0002
(505) 325-9443
Mailing address
1009 RIDGEWAY PL, FARMINGTON, NM 87401-2092
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN-77457
NM
363L00000X
Nurse Practitioner
CNP-02180
NM
363LF0000X
Family Nurse Practitioner
CNP-02180
NM
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
CNP-02180
NM
Other
Enumeration date
06/14/2013
Last updated
06/20/2023
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