Basic Information
| Provider Information | |||||||||
| NPI: | 1407239395 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | YOUNT | ||||||||
| FirstName: | KRYSTAL | ||||||||
| MiddleName: | AMBER | ||||||||
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| Credential: | CNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 623 OAK KNOLL ST | ||||||||
| Address2: | |||||||||
| City: | MINDEN | ||||||||
| State: | LA | ||||||||
| PostalCode: | 710552640 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3185607423 | ||||||||
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| Practice Location | |||||||||
| Address1: | 4864 JACKSON ST | ||||||||
| Address2: | |||||||||
| City: | MONROE | ||||||||
| State: | LA | ||||||||
| PostalCode: | 712026400 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3183307169 | ||||||||
| FaxNumber: | 3183307648 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/09/2015 | ||||||||
| LastUpdateDate: | 07/09/2015 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LP0200X | RN136124/AP08401 | LA | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Pediatrics |
No ID Information.