Healthcare Provider Details

I. General information

NPI: 1225323124
Provider Name (Legal Business Name): TANYA DENISE ARNOLD RN, MSN, FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/20/2011
Last Update Date: 06/13/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1481 WEST 10TH ST MAIL ROUTE TH112
INDIANAPOLIS IN
46202-2884
US

IV. Provider business mailing address

1481 WEST 10TH ST MAIL ROUTE TH112
INDIANAPOLIS IN
46202-2884
US

V. Phone/Fax

Practice location:
  • Phone: 317-550-0000
  • Fax: 317-988-5564
Mailing address:
  • Phone: 317-550-0000
  • Fax: 317-988-5564

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number71003609A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: