Mr Bradley Kevin Young, FNP-C | |
2041 Fisher Arch Suite 140, Virginia Beach, VA 23456 | |
(757) 301-6985 | |
Not Available |
Full Name | Mr Bradley Kevin Young |
---|---|
Gender | Male |
Speciality | Nurse Practitioner - Family |
Location | 2041 Fisher Arch Suite 140, Virginia Beach, Virginia |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1336826692 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
363LF0000X | Nurse Practitioner - Family | 11388965-4405 (Utah) | Primary |
Entity Name | Reboot Functional Health Care Corporation |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1427709526 PECOS PAC ID: 1052796604 Enrollment ID: O20220916002781 |
Mailing Address | Practice Location Address |
---|---|
Mr Bradley Kevin Young, FNP-C 8756 S 1700 E, Sandy, UT 84093-1408 Ph: (208) 380-0763 | Mr Bradley Kevin Young, FNP-C 2041 Fisher Arch Suite 140, Virginia Beach, VA 23456 Ph: (757) 301-6985 |
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Ms. Patricia G Dudley, RNC, MSN, FNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1080 First Colonial Rd, Suite 300, Virginia Beach, VA 23454 Phone: 757-481-7222 Fax: 757-390-2935 | |
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