Healthcare Provider Details

I. General information

NPI: 1538019088
Provider Name (Legal Business Name): JASMIN SANOSKI FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JASMIN WAYTASHEK

II. Dates (important events)

Enumeration Date: 02/02/2026
Last Update Date: 04/07/2026
Certification Date: 04/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

815 2ND ST SE
LITTLE FALLS MN
56345-3505
US

IV. Provider business mailing address

22859 140TH AVE
LITTLE FALLS MN
56345-4045
US

V. Phone/Fax

Practice location:
  • Phone: 612-209-7867
  • Fax:
Mailing address:
  • Phone: 612-209-7867
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number14032
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: