MEDICARE: KATHY J ARNOLD NP

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	363L00000X	Nurse Practitioner	71001899A	IN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	71001899B	OTHER	IN	CSR
2	71001899A	OTHER	IN	NURSE PRACTITIONER LIC.

General Provider Information

NPI Number	:	1275562829
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATHY J ARNOLD NP

Provider Business Mailing Address
First Line	:	124 SAGAMORE PKWY W
Second Line	:
City	:	WEST LAFAYETTE BRA
State	:	IN
Zip	:	47906-1569
Country	:	US
Telephone Number	:	765-463-6722
Fax Number	:	765-463-0905

Provider Business Practice Location Address
First Line	:	124 SAGAMORE PKWY W
Second Line	:
City	:	WEST LAFAYETTE BRA
State	:	IN
Zip	:	47906-1569
Country	:	US
Telephone Number	:	765-463-6722
Fax Number	:	765-463-0905

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

Provider Enumeration Date	:	07/03/2006
Last Update Date	:	03/07/2023

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Directions to “ KATHY J ARNOLD NP” Practice Location

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