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Individual

TANNER COLE YOUNG

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
FNP

Contact information

Practice address
851 E 5TH ST STE 108, WASHINGTON, MO 63090-3128
(636) 861-7870
Mailing address
851 E 5TH ST STE 108, WASHINGTON, MO 63090-3128
(636) 861-7870

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
2019026701
MO
363LF0000X
Family Nurse Practitioner
Primary
2024031599
MO

Other

Enumeration date
05/28/2024
Last updated
08/21/2024
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