Organization
YOUNG S. KEUM, FNP, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOSHUA TAYLOR WIGGINS (CREDENTIALING AGENT)
(704) 498-7736
Entity
Organization
Contact information
Practice address
1001 PYRAMID WAY STE 206, SPARKS, NV 89431-4470
(775) 710-8380
Mailing address
PO BOX 16793, SOUTH LAKE TAHOE, CA 96151-6793
(530) 545-8782
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
—
—
Other
Enumeration date
09/15/2022
Last updated
10/03/2022
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