Individual
MRS. KRYSTAL YOUNG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
1304 BERTRAND DR STE D5, LAFAYETTE, LA 70506-9104
(337) 446-1223
(337) 269-5964
Mailing address
1304 BERTRAND DR STE D5, LAFAYETTE, LA 70506-9104
(337) 446-1223
(337) 269-5964
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
20180184
LA
3747P1801X
Personal Care Attendant
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0000000
PPO
—
01
—
20180184
LPN
LA
Enumeration date
08/20/2019
Last updated
02/05/2020
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