Linda Lee Young, LPN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

279003-1 Issued in NY

Practice address

910 Waterloo Geneva Rd
Waterloo, NY 13165

Phone

(315) 651-1519

NPI assigned

Dec 20, 2007

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

Other names 1

• Linda Lee Derks Former name

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": "1198108800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1198108800000",
    "number": "1548444029",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "910 WATERLOO GENEVA RD",
            "city": "WATERLOO",
            "state": "NY",
            "postal_code": "131651262",
            "telephone_number": "315-651-1519"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "910 WATERLOO GENEVA RD",
            "city": "WATERLOO",
            "state": "NY",
            "postal_code": "13165",
            "telephone_number": "315-651-1519"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "LINDA",
        "middle_name": "LEE",
        "name_prefix": "Mrs.",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-12-20",
        "last_updated": "2007-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "279003-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LINDA",
            "last_name": "DERKS",
            "middle_name": "LEE",
            "credential": "LPN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Tiffany Williams
• Meredith Williamson, PT
• Danielle Wilson
• Alan G. Withiam, M.D.
• Edward McMillan Wright, PT
• Kimberly Ann Zajac

• Licensed Practical Nurse in Waterloo, NY
• Providers in Waterloo, NY by specialty
• Licensed Practical Nurse in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2007; 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.