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Individual

LISA YOUNG

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP-C

Contact information

Practice address
1007 N COUNTRY CLUB RD, ADA, OK 74820-2847
(580) 421-8700
(580) 421-8707
Mailing address
1007 N COUNTRY CLUB RD, ADA, OK 74820-2847
(580) 421-8700
(580) 421-8707

Taxonomy

Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
R 0073114
OK
363LF0000X
Family Nurse Practitioner
Primary
73114
OK

Other

Enumeration date
05/23/2016
Last updated
02/27/2020
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