Provider Demographics
NPI:1710762554
Name:YOUMANS, KELYN P (RN)
Entity type:Individual
Prefix:MRS
First Name:KELYN
Middle Name:P
Last Name:YOUMANS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:KELYN
Other - Middle Name:P
Other - Last Name:LAWS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:16514 POPLAR COVE RD
Mailing Address - Street 2:
Mailing Address - City:ONANCOCK
Mailing Address - State:VA
Mailing Address - Zip Code:23417-4049
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:36080 LANKFORD HIGHWAY
Practice Address - Street 2:
Practice Address - City:BELLE HAVEN
Practice Address - State:VA
Practice Address - Zip Code:23306
Practice Address - Country:US
Practice Address - Phone:757-442-7040
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-29
Last Update Date:2024-07-09
Deactivation Date:2023-09-01
Deactivation Code:
Reactivation Date:2024-07-03
Provider Licenses
StateLicense IDTaxonomies
VA0024190323363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner