Provider Demographics
NPI:1164494753
Name:MCLOONE, NANCY M (RN NP)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:M
Last Name:MCLOONE
Suffix:
Gender:F
Credentials:RN NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1230 E MAIN ST PO BOX 8274
Mailing Address - Street 2:MANKATO CLINIC LTD
Mailing Address - City:MANKATO
Mailing Address - State:MN
Mailing Address - Zip Code:56002-8674
Mailing Address - Country:US
Mailing Address - Phone:507-625-1811
Mailing Address - Fax:
Practice Address - Street 1:1230 E MAIN ST
Practice Address - Street 2:MANKATO CLINIC LTD
Practice Address - City:MANKATO
Practice Address - State:MN
Practice Address - Zip Code:56002-8674
Practice Address - Country:US
Practice Address - Phone:507-625-1811
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-07
Last Update Date:2020-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNR 072876-4363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN1652657OtherAMERICAS PPO
IA938134Medicaid
MN1200704OtherMEDICA
MN121222OtherUCARE
MNNA2951023875OtherPREFERRED ONE
MN477216400Medicaid
MN02Q96MCOtherBCBS
500004160OtherRR MEDICARE
MNHP41026OtherHEALTH PARTNERS
MN1652657OtherAMERICAS PPO
500004160OtherRR MEDICARE