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General NPI Number Information
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NPI Number | 1740926948
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Entity Type | Individual
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Provider Name | BETH ANN FOBLE RN
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Gender | Female
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Dates
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Enumeration Date | 05/10/2022
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Last Update Date | 05/23/2022
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Provider Practice Location Address
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Address Line | 2115 W PARK DR
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City | LORAIN
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State | OH
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Zip | 44053-1138
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Country | US
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Telephone | 440-989-4900
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Fax |
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Provider Business Mailing Address
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Address Line | 33393 ELECTRIC BLVD APT D5
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City | AVON LAKE
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State | OH
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Zip | 44012-1259
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Country | US
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Telephone |
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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 | 163WA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Registered Nurse
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License Number | RN.453401
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | RN.453401
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License Number State | OH
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