Kierra Degale Youngblood

Primary specialty

Home Health Registered NurseTaxonomy code 163WH0200X

License

RN-143657 Issued in LA

Practice address

3650 Lakeside Dr
Shreveport, LA 71119-6516

Phone

(318) 771-4732

Fax

(318) 771-4732

NPI assigned

Apr 21, 2021

Last updated

Apr 21, 2021By the provider in NPPES

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

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Abundant Grace Home Care LLC

  • Home Health Agency
  • Shreveport, LA
  • NPI 1073182424
  NPD Authorized official

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

{
    "created_epoch": "1618963200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618963200000",
    "number": "1700468691",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1651 E 70TH ST # 264",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711055115",
            "telephone_number": "318-771-4732",
            "fax_number": "318-606-2104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3650 LAKESIDE DR",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711196516",
            "telephone_number": "318-771-4732",
            "fax_number": "318-771-4732"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNGBLOOD",
        "first_name": "KIERRA",
        "middle_name": "DEGALE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-04-21",
        "last_updated": "2021-04-21",
        "certification_date": "2021-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WH0200X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Registered Nurse, Home Health",
            "state": "LA",
            "license": "RN-143657",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Treasure M Young
• Allison Youngblood
• Angela Youngblood
• Christa Lathon Youngblood
• Corina Renee Youngblood, RN
• Shannon Leonnie Youngblood, CRNA
• Sheena Renaye Youngblood, APRN, FNP-C
• Tikila Youngblood
• Youree Associates Inc
• Youree Associates Inc Apc

• Home Health Registered Nurse in Shreveport, LA
• Providers in Shreveport, LA by specialty
• Home Health Registered Nurse in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2021; 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.