Healthcare Provider Details

I. General information

NPI: 1811482003
Provider Name (Legal Business Name): BETH ANN WHALEY APRN-CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: BETH ANN SIMON

II. Dates (important events)

Enumeration Date: 06/29/2018
Last Update Date: 01/12/2026
Certification Date: 01/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

164 E MAIN ST
MOUNT STERLING OH
43143-1145
US

IV. Provider business mailing address

700 ACKERMAN RD STE 2120
COLUMBUS OH
43202-1559
US

V. Phone/Fax

Practice location:
  • Phone: 740-956-1360
  • Fax:
Mailing address:
  • Phone: 740-845-6735
  • Fax: 740-845-6736

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN.CNP.022972
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAPRN.CNP.022972
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: