Provider Demographics
NPI:1154296572
Name:RODRIGUEZ YANES, RENE JAVIER (FNP-BC)
Entity type:Individual
Prefix:
First Name:RENE
Middle Name:JAVIER
Last Name:RODRIGUEZ YANES
Suffix:
Gender:M
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:39 HOLLOW TREE RD
Mailing Address - Street 2:
Mailing Address - City:NORWALK
Mailing Address - State:CT
Mailing Address - Zip Code:06854-2815
Mailing Address - Country:US
Mailing Address - Phone:475-333-9401
Mailing Address - Fax:
Practice Address - Street 1:494 ELM ST
Practice Address - Street 2:
Practice Address - City:STAMFORD
Practice Address - State:CT
Practice Address - Zip Code:06902-5115
Practice Address - Country:US
Practice Address - Phone:203-325-0200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-10-07
Last Update Date:2025-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT12.015658363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily