Provider Demographics
NPI:1871170696
Name:YOUNG, DELORIS (RN)
Entity type:Individual
Prefix:MS
First Name:DELORIS
Middle Name:
Last Name:YOUNG
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2116 S MIAMI BLVD
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27703-5708
Mailing Address - Country:US
Mailing Address - Phone:919-957-3354
Mailing Address - Fax:919-957-3394
Practice Address - Street 1:509 LINDEN AVE
Practice Address - Street 2:
Practice Address - City:KINSTON
Practice Address - State:NC
Practice Address - Zip Code:28501-1733
Practice Address - Country:US
Practice Address - Phone:877-361-3354
Practice Address - Fax:919-957-3394
Is Sole Proprietor?:No
Enumeration Date:2021-03-26
Last Update Date:2021-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCHC5894163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC919-824-5915OtherOFFICE CELL#