Provider Demographics
NPI:1174983373
Name:YOUNG, LAURA HASTINGS (RN, AGNP-C)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:HASTINGS
Last Name:YOUNG
Suffix:
Gender:F
Credentials:RN, AGNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:856 GEORGES FORK RD
Mailing Address - Street 2:
Mailing Address - City:BURNSVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28714-7842
Mailing Address - Country:US
Mailing Address - Phone:828-682-9675
Mailing Address - Fax:828-682-4713
Practice Address - Street 1:856 GEORGES FORK RD
Practice Address - Street 2:
Practice Address - City:BURNSVILLE
Practice Address - State:NC
Practice Address - Zip Code:28714-7842
Practice Address - Country:US
Practice Address - Phone:828-682-9675
Practice Address - Fax:828-682-4713
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-01
Last Update Date:2022-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5008327363LA2200X, 363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology