MANDY RENAE DEYOUNG APRN NPI 1295211274

NPI Information

  • NPI: 1295211274
  • Provider Name: MANDY RENAE DEYOUNG, APRN
  • Classification: Nurse Practitioner - 363LW0102X
  • Specialization: Women's Health
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 15901 BASS RD STE 100
    FORT MYERS, FL
    ZIP 33908
  • Phone: (239) 343-6100

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NPI Details

Mandy Renae Deyoung, APRN is a women's health nurse practitioner in Fort Myers, FL. Mandy Renae Deyoung, APRN NPI is 1295211274. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

15901 BASS RD STE 100
FORT MYERS, FL
ZIP 33908
Phone: (239) 343-6100
Fax: (239) 343-9925

The NPI 1295211274 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 7/13/2018 and was last updated on 1/30/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363LW0102XNurse PractitionerWomen's HealthAPRN9308253FLORIDAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1100274400MEDICAIDFLORIDA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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