Jon A Vanloon, MD
Individual provider Active NPI Psychiatry Physician · Wabasha, MN
NPI 1245279504 · NPPES record last updated Mar 6, 2019
Key facts
- NPI
- 1245279504
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychiatry Physician 2084P0800X
- License
- 38363 (MN)
- Practice address
- 1200 Grant Blvd W
Wabasha, MN 55981-1042 - Phone
- (651) 565-5600
- NPI assigned
- Jun 5, 2006
- 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)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 38363 | MN | MD | Psychiatry Physician |
Interoperability endpoints
- jvanloon472626@direct.emplifyhealth.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 38363 | MN | Yes |
Addresses
Primary practice location
1200 Grant Blvd W
Wabasha, MN 55981-1042
Mailing address
1200 Grant Blvd W
Wabasha, MN 55981-1042
Phone (651) 565-5600
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All providers in Wabasha, MN · Psychiatry Physician in Minnesota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 6, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.