Provider Demographics
NPI:1427931666
Name:YOUNG, DELISA E
Entity type:Individual
Prefix:
First Name:DELISA
Middle Name:E
Last Name:YOUNG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:780 NEW MAGNOLIA CT
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30349-4077
Mailing Address - Country:US
Mailing Address - Phone:877-725-4463
Mailing Address - Fax:
Practice Address - Street 1:780 NEW MAGNOLIA CT
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30349-4077
Practice Address - Country:US
Practice Address - Phone:877-725-4463
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-28
Last Update Date:2025-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA376J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker