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General NPI Number Information
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NPI Number | 1629611900
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Entity Type | Individual
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Provider Name | BETH ANN IASIMONE RN
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Gender | Female
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Dates
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Enumeration Date | 10/19/2019
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Last Update Date | 11/04/2021
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Provider Practice Location Address
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Address Line | 275 N GAINES ST
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City | OAK HILL
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State | FL
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Zip | 32759-9537
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Country | US
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Telephone | 321-220-3895
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Fax | 321-265-4690
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Provider Business Mailing Address
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Address Line | PO BOX 731
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City | OAK HILL
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State | FL
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Zip | 32759-0731
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Country | US
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Telephone | 321-220-3895
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Fax | 321-265-4690
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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 | RN9190670
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 163WA2000X
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Taxonomy Name | Administrator Registered Nurse
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License Number | RN9190670
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 163WH0200X
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Taxonomy Name | Home Health Registered Nurse
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License Number | RN9190670
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License Number State | FL
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Taxonomy #4
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Taxonomy Code | 163WI0500X
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Taxonomy Name | Infusion Therapy Registered Nurse
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License Number | RN9190670
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License Number State | FL
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