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General NPI Number Information
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NPI Number | 1407292220
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Entity Type | Individual
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Provider Name | LAUREN NEIGHBORS YOUTZ PA-C
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Gender | Female
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Dates
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Enumeration Date | 05/20/2013
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Last Update Date | 04/12/2023
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Provider Practice Location Address
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Address Line | 479 HIGHWAY 20 E
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City | FREEPORT
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State | FL
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Zip | 32439-3931
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Country | US
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Telephone | 850-880-6568
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Fax |
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Provider Business Mailing Address
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Address Line | 479 E. HWY 20
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City | FREEPORT
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State | FL
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Zip | 32439
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Country | US
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Telephone | 850-880-6568
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 9106427
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License Number State | FL
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