Individual
TRACY P YOUNG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
1100 ANDRE ST STE 300, YPS ANESTHESIA, NEW IBERIA, LA 70563-2159
(337) 364-9225
(337) 364-6094
Mailing address
PO BOX 20452, YPS-CRED, COLUMBUS, OH 43220-0452
(614) 442-2406
(614) 442-2410
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
RN085074
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1111155
—
LA
01
—
1629036785
BCBS LA
LA
05
—
198748902
—
TX
05
—
198748905
—
TX
01
—
8082UU
BCBS TX
TX
Enumeration date
05/01/2006
Last updated
06/14/2013
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