Organization
I WANT TO BE HEALTHY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LUCHIA LYNNETTE YOUNG (PROVIDER)
(832) 964-4022
Entity
Organization
Contact information
Practice address
18247 N TOYA ST, MARICOPA, AZ 85138-2905
(832) 964-4022
(347) 960-4805
Mailing address
18247 N TOYA ST, MARICOPA, AZ 85138-2905
(832) 964-4022
(347) 960-4805
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
AP3446
AZ
363LF0000X
Family Nurse Practitioner
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
AP5602
AZ
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
Z184231
MEDICARE PTAN
AZ
Enumeration date
11/20/2015
Last updated
10/08/2020
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