Individual
MRS. REBECCA VANESSA YOUNG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
109 E 5TH ST, CARUTHERSVILLE, MO 63830-1417
(573) 359-9803
(573) 359-0990
Mailing address
6738 STATE HIGHWAY 77, BENTON, MO 63736-8238
(573) 313-2500
(573) 313-2505
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
2005027734
MO
363LF0000X
Family Nurse Practitioner
Primary
2013013681
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
420009234
—
MO
Enumeration date
08/29/2013
Last updated
03/12/2020
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