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NPI Code Detail

MEDICARE: STACEY VASKO

MEDICARE: STACEY VASKO
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
1363A00000XPhysician Assistant50.005415RXOH

General Provider Information

NPI Number : 1730681453
Entity Type Code : Individual
Provider Name (Legal Business Name) : STACEY VASKO
Provider Business Mailing Address
First Line : 22 TURTLE CREEK CIR
Second Line :
City : SWANTON
State : OH
Zip : 43558-8591
Country : US
Telephone Number : 419-825-5151
Fax Number : 419-825-5901
Provider Business Practice Location Address
First Line : 22 TURTLE CREEK CIR
Second Line :
City : SWANTON
State : OH
Zip : 43558-8591
Country : US
Telephone Number : 419-825-5151
Fax Number : 419-825-5901
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/08/2018
Last Update Date : 03/03/2022

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Directions to “ STACEY VASKO ” Practice Location

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