Provider Demographics
NPI:1629310222
Name:VYAS, NEETA (NP)
Entity Type:Individual
Prefix:
First Name:NEETA
Middle Name:
Last Name:VYAS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:652 S MEDICAL CENTER DR STE 320
Mailing Address - Street 2:
Mailing Address - City:SAINT GEORGE
Mailing Address - State:UT
Mailing Address - Zip Code:84790-7266
Mailing Address - Country:US
Mailing Address - Phone:435-251-3950
Mailing Address - Fax:435-251-3951
Practice Address - Street 1:652 S. MEDICAL CENTER DRIVE SUITE 320
Practice Address - Street 2:
Practice Address - City:SAINT GEORGE
Practice Address - State:UT
Practice Address - Zip Code:84790-4048
Practice Address - Country:US
Practice Address - Phone:435-251-3950
Practice Address - Fax:435-251-3951
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-21
Last Update Date:2015-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT4858581-4405363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily