Healthcare Provider Details

I. General information

NPI: 1447709845
Provider Name (Legal Business Name): KATIE LEE ARNOLD MSN, APRN, FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/26/2016
Last Update Date: 03/31/2022
Certification Date: 03/31/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

220 J L WHITE DR STE 100
JASPER GA
30143-4894
US

IV. Provider business mailing address

188 16TH AVE SUITE 107
DAYTON TN
37321-1036
US

V. Phone/Fax

Practice location:
  • Phone: 706-253-8001
  • Fax:
Mailing address:
  • Phone: 423-775-6933
  • Fax: 423-775-3372

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number21853
License Number StateTN
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN294208
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: