Individual ProviderVivian PashovaNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersPractice Address7222 Engle Rd., Fort Wayne, IN 46804(260) 432-5005PECOS EnrollmentBased on the most recent information from CMS, provider Vivian Pashova is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records yesterday at 12:57 PM.Profile DetailsProvider ID1821854563Provider TypeIndividualFull NamePashova, VivianCredentialFNP-CGenderFemaleSole ProprietorNoEnumeration Date2/21/2024Last Updated2/21/2024Contact InformationPractice LocationPractice Address7222 Engle Rd., Fort Wayne, IN 46804Phone(260) 432-5005FaxUnlisted FaxMailing LocationMailing Address7222 Engle Rd., Fort Wayne, IN 46804PhoneUnlisted PhoneFaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode363LF0000XPrimaryDescriptionNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersLicense71014942AIndiana