Provider Demographics
NPI:1679144711
Name:YAHN, ELIZABETH (MS, RD, LD, CLC)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:
Last Name:YAHN
Suffix:
Gender:F
Credentials:MS, RD, LD, CLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7424 POND CIR
Mailing Address - Street 2:
Mailing Address - City:SPRING HILL
Mailing Address - State:FL
Mailing Address - Zip Code:34606-4338
Mailing Address - Country:US
Mailing Address - Phone:352-513-6010
Mailing Address - Fax:
Practice Address - Street 1:12604 TATTERSALL PARK LN
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33625-3908
Practice Address - Country:US
Practice Address - Phone:656-201-0211
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-09
Last Update Date:2024-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLND9534133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered