MANDY RENAE DEYOUNG APRN NPI 1295211274

NPI Information

NPI: 1295211274
Provider Name: MANDY RENAE DEYOUNG, APRN
Classification: Nurse Practitioner - 363LW0102X
Entity Type: Individual

Specialization: Women's Health

PECOS Registration: Yes

Address:
15901 BASS RD STE 100
FORT MYERS, FL
ZIP 33908
Phone: (239) 343-6100
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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
1	363LW0102X	Nurse Practitioner	Women's Health	APRN9308253	FLORIDA	Yes

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
1	100274400	MEDICAID	FLORIDA

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: 11/14/2023

NPI Synchronization or Removal

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