Individual
JONATHAN VANN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3001 SAINT ROSE PKWY, HENDERSON, NV 89052-3839
(702) 492-8592
(702) 492-8045
Mailing address
PO BOX 33269, PHOENIX, AZ 85067-3269
(602) 406-4786
(916) 636-4358
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
DO3662
NV
208D00000X
General Practice Physician
DO3662
NV
208M00000X
Hospitalist Physician
Primary
DO3662
NV
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1144808304
—
NV
Enumeration date
03/30/2021
Last updated
02/10/2026
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