| Rvision Health Pc | |
|
6055 Nathan Ln N Ste 200 Plymouth MN 55442-1675 | |
| (763) 513-4300 | |
| Not Available |
| Full Name | Rvision Health Pc |
|---|---|
| Speciality | Clinic/Center |
| Location | 6055 Nathan Ln N Ste 200, Plymouth, Minnesota |
| Authorized Official Name and Position | Matt Mesnik (CHIEF MEDICAL OFFICER) |
| Authorized Official Contact | 7636704265 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Rvision Health Pc 6055 Nathan Lane N Suite 200 Attn: Anne Froistad Plymouth MN 55442 Ph: (763) 513-4377 | Rvision Health Pc 6055 Nathan Ln N Ste 200 Plymouth MN 55442-1675 Ph: (763) 513-4300 |
| NPI Number | 1386383693 |
|---|---|
| Provider Enumeration Date | 06/03/2022 |
| Last Update Date | 06/03/2022 |
| Medicare PECOS PAC ID | 0941676993 |
|---|---|
| Medicare Enrollment ID | O20221017003250 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1386383693 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
| Provider Name | Stacy Adair Woodard |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740776707 PECOS PAC ID: 4880944644 Enrollment ID: I20180829002395 |
| Provider Name | Matthew Mesnik |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1124060272 PECOS PAC ID: 8729072921 Enrollment ID: I20221017003270 |
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