Healthcare Provider Details

I. General information

NPI: 1881803278
Provider Name (Legal Business Name): BETH RENEE ARMSTRONG RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/22/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

555 LEXINGTON AVE
MANSFIELD OH
44907-1502
US

IV. Provider business mailing address

555 LEXINGTON AVE
MANSFIELD OH
44907-1502
US

V. Phone/Fax

Practice location:
  • Phone: 419-774-4543
  • Fax: 419-774-4590
Mailing address:
  • Phone: 419-774-4543
  • Fax: 419-774-4590

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC1500X
TaxonomyCommunity Health Registered Nurse
License Number139036
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: