Healthcare Provider Details

I. General information

NPI: 1750954111
Provider Name (Legal Business Name): JOSEPH CHRISTOPHER ARNOLD ARNP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/22/2021
Last Update Date: 12/14/2022
Certification Date: 11/29/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3421 W 9TH ST
WATERLOO IA
50702-5401
US

IV. Provider business mailing address

3421 W 9TH ST
WATERLOO IA
50702-5401
US

V. Phone/Fax

Practice location:
  • Phone: 319-272-8000
  • Fax:
Mailing address:
  • Phone: 319-272-8000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number69397
License Number StateID
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberA164307
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: