Provider Demographics
NPI:1174041511
Name:VANLOAN, RHONDA (LPN)
Entity Type:Individual
Prefix:
First Name:RHONDA
Middle Name:
Last Name:VANLOAN
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:510 FAIGLE RD BLDG D
Mailing Address - Street 2:
Mailing Address - City:STARLIGHT
Mailing Address - State:PA
Mailing Address - Zip Code:18461-1109
Mailing Address - Country:US
Mailing Address - Phone:607-644-5071
Mailing Address - Fax:
Practice Address - Street 1:510 FAIGLE RD BLDG D
Practice Address - Street 2:
Practice Address - City:STARLIGHT
Practice Address - State:PA
Practice Address - Zip Code:18461-1109
Practice Address - Country:US
Practice Address - Phone:607-644-5071
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-09-06
Last Update Date:2017-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY271479164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse