Individual
COREY JUDE YOUNG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
AG-ACNP
Contact information
Practice address
800 E DAWSON ST, TYLER, TX 75701-2036
(903) 593-8441
Mailing address
11159 TWIN SPIRES DR, FLINT, TX 75762-6335
(318) 542-0559
Taxonomy
Speciality
Code
Description
License number
State
163WC0200X
Critical Care Medicine Registered Nurse
879083
TX
363L00000X
Nurse Practitioner
1075861
TX
363LA2100X
Acute Care Nurse Practitioner
Primary
1075861
TX
Other
Enumeration date
03/23/2022
Last updated
07/29/2022
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