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General NPI Number Information
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NPI Number | 1326294604
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Entity Type | Individual
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Provider Name | FRANK JOSEPH SIMONETTI JR. LVN
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Gender | Male
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Dates
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Enumeration Date | 08/18/2008
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Last Update Date | 08/18/2008
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Provider Practice Location Address
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Address Line | 550 POPE AVE MUNSON ARMY HEALTH CENTER (ATTN: MCXN-COD, MS COTTON)
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City | FORT LEAVENWORTH
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State | KS
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Zip | 66027-2332
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Country | US
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Telephone | 913-684-6562
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Fax | 913-684-6208
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Provider Business Mailing Address
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Address Line | 810 IOWA AVE
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City | FORT LEAVENWORTH
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State | KS
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Zip | 66027-1138
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Country | US
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Telephone | 808-223-2436
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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 | 164X00000X
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Taxonomy Name | Licensed Vocational Nurse
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License Number | 129849
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License Number State | TX
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