Individual
TIFFANY YOUTZY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
1454 N COUNTY ROAD 2050 E, CARTHAGE, IL 62321-3551
(217) 357-8500
Mailing address
1317 CRIMSON KING CT, GENESEO, IL 61254-8647
(309) 945-7095
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
041-345516
IL
163W00000X
Registered Nurse
14-95155-031
KS
163W00000X
Registered Nurse
2003017943
MO
367500000X
Certified Registered Nurse Anesthetist
Primary
55615
KS
Other
Enumeration date
07/18/2007
Last updated
04/08/2019
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