Individual
BRADLEY HARPER YOUNG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP-BC
Contact information
Practice address
110 RT STANLEY SR PL, LYONS, GA 30436-5623
(912) 526-9355
(912) 526-8622
Mailing address
110 RT STANLEY SR PL, LYONS, GA 30436-5623
(912) 526-9355
(912) 526-8622
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
RN218687
GA
363LF0000X
Family Nurse Practitioner
5004636
NC
363LF0000X
Family Nurse Practitioner
RN218687
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003116137A
—
GA
01
—
RN218687
STATE LICENSE
GA
Enumeration date
01/22/2010
Last updated
03/16/2021
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