Individual
LORI A YOUNG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1500 PROVIDENT DR STE A, WARSAW, IN 46580-3297
(574) 372-7637
(574) 372-7689
Mailing address
7950 W JEFFERSON BLVD, SUITE 2121, FORT WAYNE, IN 46804-4140
(260) 407-8000
(260) 407-8004
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
71001143
IN
363LF0000X
Family Nurse Practitioner
Primary
71001143A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200329130
—
IN
Enumeration date
07/21/2006
Last updated
09/17/2020
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