Provider Demographics
NPI:1558153742
Name:DUTCHES, YARI (MHS)
Entity type:Individual
Prefix:
First Name:YARI
Middle Name:
Last Name:DUTCHES
Suffix:
Gender:F
Credentials:MHS
Other - Prefix:
Other - First Name:APRIL
Other - Middle Name:DENISE
Other - Last Name:HAGAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1878 E NINE MILE RD APT 1403
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32514-5408
Mailing Address - Country:US
Mailing Address - Phone:850-501-4242
Mailing Address - Fax:
Practice Address - Street 1:1878 E NINE MILE RD APT 1403
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32514-5408
Practice Address - Country:US
Practice Address - Phone:850-501-4242
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-21
Last Update Date:2025-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1235599267Medicaid