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General NPI Number Information
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NPI Number | 1164980934
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Entity Type | Individual
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Provider Name | JEFFREY A IANNONE APRN
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Gender | Male
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Dates
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Enumeration Date | 03/11/2019
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Last Update Date | 06/08/2026
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Provider Practice Location Address
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Address Line | 23425 COMMERCE PARK STE 104
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City | BEACHWOOD
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State | OH
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Zip | 44122-5848
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Country | US
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Telephone | 216-831-2900
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Fax |
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Provider Business Mailing Address
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Address Line | 23425 COMMERCE PARK STE 104
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City | BEACHWOOD
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State | OH
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Zip | 44122-5848
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Country | US
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Telephone | 216-831-2900
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | RN.408190
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | APRN.CNP.0030192
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License Number State | OH
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