Individual
THOMAS D. VASOVSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP
Contact information
Practice address
9900 BREN RD E, MINNETONKA, MN 55343-9664
(928) 202-0159
Mailing address
953 N SOLIZ ST, DEWEY, AZ 86327-8221
(928) 202-0159
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
590141
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1485989-03
—
TX
01
—
8N9143
BLUE SHIELD
TX
01
—
P00269380
RR/MEDICARE
TX
Enumeration date
04/07/2006
Last updated
07/09/2020
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