Provider Demographics
NPI:1407292220
Name:YOUTZ, LAUREN NEIGHBORS (PA-C)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:NEIGHBORS
Last Name:YOUTZ
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:479 E. HWY 20
Mailing Address - Street 2:
Mailing Address - City:FREEPORT
Mailing Address - State:FL
Mailing Address - Zip Code:32439
Mailing Address - Country:US
Mailing Address - Phone:850-880-6568
Mailing Address - Fax:
Practice Address - Street 1:479 HIGHWAY 20 E
Practice Address - Street 2:
Practice Address - City:FREEPORT
Practice Address - State:FL
Practice Address - Zip Code:32439-3931
Practice Address - Country:US
Practice Address - Phone:850-880-6568
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-20
Last Update Date:2023-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9106427363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant