Provider Demographics
NPI:1942282504
Name:DYER, ELIZABETH GRACE (NP)
Entity type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:GRACE
Last Name:DYER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
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Mailing Address - Street 1:106 NATE WHIPPLE HWY STE 101
Mailing Address - Street 2:
Mailing Address - City:CUMBERLAND
Mailing Address - State:RI
Mailing Address - Zip Code:02864-1403
Mailing Address - Country:US
Mailing Address - Phone:401-739-7380
Mailing Address - Fax:401-658-2020
Practice Address - Street 1:982 TIOGUE AVE
Practice Address - Street 2:
Practice Address - City:COVENTRY
Practice Address - State:RI
Practice Address - Zip Code:02816-6116
Practice Address - Country:US
Practice Address - Phone:401-821-6800
Practice Address - Fax:401-821-8513
Is Sole Proprietor?:No
Enumeration Date:2005-11-18
Last Update Date:2025-07-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
RINP37099363L00000X
RIAPRN01326363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
P24740Medicare UPIN