Lacresha Danyell Youngblood

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

L043813 Issued in AR

Practice address

755 S Beckham Ave
Tyler, TX 75701-1903

Phone

(903) 534-4684

NPI assigned

Feb 19, 2018

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1518998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1518998400000",
    "number": "1437659125",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2801 BILL OWENS PKWY APT 203",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "756052169",
            "telephone_number": "903-490-6430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "755 S BECKHAM AVE",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757011903",
            "telephone_number": "903-534-4684"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNGBLOOD",
        "first_name": "LACRESHA",
        "middle_name": "DANYELL",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-02-19",
        "last_updated": "2018-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "AR",
            "license": "L043813",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David L Young, MD
• Erin Young, LCSW
• Nicholas Reid Young
• Stephen Keith Young, CRNA
• Steven Dewayne Young Sr.
• Malcolm Youngblood, DDS
• Janice Younger, LCSW
• Debra L Youngs, CRNA
• Firas Younis
• Youth and Family Enrichment Centers, Inc

• Licensed Practical Nurse in Tyler, TX
• Providers in Tyler, TX by specialty
• Licensed Practical Nurse in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.