Provider Demographics
NPI:1164496493
Name:YURT, EVELYN C (ARNP)
Entity Type:Individual
Prefix:
First Name:EVELYN
Middle Name:C
Last Name:YURT
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10301 HAGEN RANCH RD
Mailing Address - Street 2:STE C130
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33437
Mailing Address - Country:US
Mailing Address - Phone:561-736-7313
Mailing Address - Fax:561-736-2309
Practice Address - Street 1:10301 HAGEN RANCH RD
Practice Address - Street 2:STE C130
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33437
Practice Address - Country:US
Practice Address - Phone:561-736-7313
Practice Address - Fax:561-736-2309
Is Sole Proprietor?:No
Enumeration Date:2006-02-14
Last Update Date:2013-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1944762363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL306869200Medicaid