Provider Demographics
NPI:1669979613
Name:VENDRYES, LAUREN (NP)
Entity type:Individual
Prefix:MRS
First Name:LAUREN
Middle Name:
Last Name:VENDRYES
Suffix:
Gender:F
Credentials:NP
Other - Prefix:MS
Other - First Name:LAUREN
Other - Middle Name:
Other - Last Name:PHILBRICK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:PO BOX 415348
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02241-5348
Mailing Address - Country:US
Mailing Address - Phone:800-225-8885
Mailing Address - Fax:508-334-1977
Practice Address - Street 1:55 LAKE AVENUE NORTH
Practice Address - Street 2:
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01655-0002
Practice Address - Country:US
Practice Address - Phone:508-334-3850
Practice Address - Fax:508-334-9108
Is Sole Proprietor?:No
Enumeration Date:2018-04-06
Last Update Date:2023-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2273266363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA110155510AMedicaid