Thomas Vansant, RN

Individual provider Active NPI Emergency Registered Nurse · Capitan, NM

NPI 1972128494 · NPPES record last updated Jun 10, 2020

Key facts

NPI
1972128494
Entity type
Individual (NPI type 1)
Primary specialty
Emergency Registered Nurse 163WE0003X
License
RN-77499 (NM)
Practice address
114 Talla Quaw TRL
Capitan, NM 88316-5034
Phone
(931) 408-0015
NPI assigned
Jun 10, 2020
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
RN-77499NMMDEmergency Registered Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Registered Nurse 163WE0003X RN-77499 NM Yes

Addresses

Primary practice location

114 Talla Quaw TRL
Capitan, NM 88316-5034

Mailing address

114 Talla Quaw TRL
Capitan, NM 88316-5034
Phone (931) 408-0015

Other practice location 1

Kayenta Health Center
Hwy 160 Mile post 394.3
Kayenta, AZ 86033
Phone (928) 697-4000

Other providers in Capitan, NM

All providers in Capitan, NM · Emergency Registered Nurse in New Mexico

Sources for this page

Verify at the official NPI Registry.