MEDICARE: ELIZABETH ARNOLD RN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163W00000X	Registered Nurse	205447	OK

General Provider Information

NPI Number	:	1154042745
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELIZABETH ARNOLD RN

Provider Business Mailing Address
First Line	:	4130 S ROCKFORD PL
Second Line	:
City	:	TULSA
State	:	OK
Zip	:	74105-4046
Country	:	US
Telephone Number	:	918-237-9515
Fax Number	:

Provider Business Practice Location Address
First Line	:	4130 S ROCKFORD PL
Second Line	:
City	:	TULSA
State	:	OK
Zip	:	74105-4046
Country	:	US
Telephone Number	:	918-237-9515
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/12/2022
Last Update Date	:	09/12/2022

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