Provider Demographics
NPI:1689648313
Name:DEYOUNG, LYNN LENEVE (MD, PHD)
Entity Type:Individual
Prefix:
First Name:LYNN
Middle Name:LENEVE
Last Name:DEYOUNG
Suffix:
Gender:F
Credentials:MD, PHD
Other - Prefix:
Other - First Name:LYNN
Other - Middle Name:DEYOUNG
Other - Last Name:HELSETH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:839 W CONGRESS ST
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85745-2819
Mailing Address - Country:US
Mailing Address - Phone:520-204-0593
Mailing Address - Fax:
Practice Address - Street 1:839 W CONGRESS ST
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85745-2819
Practice Address - Country:US
Practice Address - Phone:520-204-0593
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-17
Last Update Date:2023-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ32975207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ892522Medicaid
AZI19643Medicare UPIN
AZZ106831Medicare PIN