Deyoung, Mandy Renae
Deyoung, Mandy Renae is an sole proprietor health care provider with primary practice located at 15901 Bass Rd Ste 100 , Fort Myers FL 33908. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Women's Health, which is considered as her primary health care specialty. Deyoung, Mandy Renae can be contacted via phone (239) 343-6100.Contact Information
Primary practice address
15901 Bass Rd Ste 100
Fort Myers FL 33908
Phone: (239) 343-6100
Fax: (239) 343-9925
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Women's Health | 363LW0102X | APRN9308253 | Florida |
Profile Details
| NPI number | 1295211274 |
|---|---|
| LBN Legal business name | Deyoung, Mandy Renae |
| Credentials | Advanced Practice Registered Nurse (APRN) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jul 13th, 2018 |
| Last updated | Jan 30th, 2020 - about 5 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1295211274 | NPPES |
| Florida | MEDICAID | 100274400 |
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