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BRADLEY HARPER YOUNG FNP-BC

Family >> Nurse Practitioner >> Physician Assistants & Advanced Practice Nursing Providers

Registrant NPI Number: 1912238460

Individual Registrant:
 BRADLEY HARPER YOUNG FNP-BC
Gender: M
Not Sole Proprietor

Location and contact information for practice:
110 RT STANLEY SR PL  LYONS, GA 30436-5623 US
Tel: 912-526-9355  Fax: 912-526-8622

Contact information for business:
110 RT STANLEY SR PL  LYONS, GA 30436-5623 US
Tel: 912-526-9355  Fax: 912-526-8622

Registration Information:
NPI: 1912238460
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
N363LF0000XPhysician Assistants & Advanced Practice Nursing Providers
Nurse Practitioner
Family
NC5004636
N363LF0000XPhysician Assistants & Advanced Practice Nursing Providers
Nurse Practitioner
GARN218687
Y363L00000XPhysician Assistants & Advanced Practice Nursing Providers
Nurse Practitioner
GARN218687

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType
003116137AGA05
STATE LICENSERN218687GA01




HEALTH CARE JOBS GA - Page 1



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