MEDICARE: RAYMOND LEE VASQUEZ FNP-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	2015034087	MO

General Provider Information

NPI Number	:	1851492292
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RAYMOND LEE VASQUEZ FNP-C

Provider Business Mailing Address
First Line	:	1741 NE DOUGLAS ST STE 102
Second Line	:
City	:	LEES SUMMIT
State	:	MO
Zip	:	64086-4704
Country	:	US
Telephone Number	:	816-525-6688
Fax Number	:	877-673-4862

Provider Business Practice Location Address
First Line	:	1741 NE DOUGLAS ST STE 102
Second Line	:
City	:	LEES SUMMIT
State	:	MO
Zip	:	64086-4704
Country	:	US
Telephone Number	:	816-525-6688
Fax Number	:	877-673-4862

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/26/2006
Last Update Date	:	10/28/2025

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