Provider Demographics
NPI:1689244709
Name:VYAS, SHRENIK (FNP-C)
Entity Type:Individual
Prefix:MR
First Name:SHRENIK
Middle Name:
Last Name:VYAS
Suffix:
Gender:M
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 WAKE ROBIN RD UNIT 103
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:RI
Mailing Address - Zip Code:02865-4241
Mailing Address - Country:US
Mailing Address - Phone:401-334-3105
Mailing Address - Fax:
Practice Address - Street 1:2 WAKE ROBIN RD UNIT 103
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:RI
Practice Address - Zip Code:02865-4241
Practice Address - Country:US
Practice Address - Phone:401-334-3105
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-30
Last Update Date:2024-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIAPRN02669363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily