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Individual

NICOLE BRIANA VASINKO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
793 OLD ROUTE 119 HWY N, INDIANA, PA 15701-1372
(724) 465-5576
(724) 465-5532
Mailing address
427 SAWMILL RD, GREENSBURG, PA 15601-6468
(724) 972-3804

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
MA057903
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000670775
OPTUM
PA
01
103197501
MA
PA
01
13624851
CAQH
PA
Enumeration date
10/01/2015
Last updated
11/06/2024
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