Healthcare Provider Details

I. General information

NPI: 1366801052
Provider Name (Legal Business Name): ELIZABETH ARNETT CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/23/2016
Last Update Date: 02/23/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 HEALTH PARK BLVD SUITE 3002
ST AUGUSTINE FL
32086-3707
US

IV. Provider business mailing address

300 HEALTH PARK BLVD SUITE 3002
ST AUGUSTINE FL
32086-3707
US

V. Phone/Fax

Practice location:
  • Phone: 904-819-1500
  • Fax:
Mailing address:
  • Phone: 904-819-1500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License NumberARNP9386975
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: