MEDICARE: AMANDA MARIE YOUTZY BSN, RN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163WP2201X	Ambulatory Care Registered Nurse	149881	IA

General Provider Information

NPI Number	:	1982388286
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMANDA MARIE YOUTZY BSN, RN

Provider Business Mailing Address
First Line	:	478 TIFFANY DR
Second Line	:
City	:	MASON CITY
State	:	IA
Zip	:	50401-1535
Country	:	US
Telephone Number	:	646-149-4500
Fax Number	:	641-494-5028

Provider Business Practice Location Address
First Line	:	478 TIFFANY DR
Second Line	:
City	:	MASON CITY
State	:	IA
Zip	:	50401-1535
Country	:	US
Telephone Number	:	646-149-4500
Fax Number	:	641-494-5028

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/15/2023
Last Update Date	:	06/15/2023

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