Individual
SHANDREA RODRIGUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
WAYLAND MEDICAL ASSOCIATES, 160 WAYLAND AVE, PROVIDENCE, RI 02906
(401) 521-1221
(401) 454-4189
Mailing address
160 WAYLAND AVE, PROVIDENCE, RI 02906-4304
(401) 521-1221
(401) 454-4189
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN42313
RI
363LF0000X
Family Nurse Practitioner
Primary
APRN01603
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
SR67488
—
RI
Enumeration date
07/20/2007
Last updated
11/01/2021
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