Healthcare Provider Details

I. General information

NPI: 1861914582
Provider Name (Legal Business Name): KORTNEY ARNOLD APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/14/2017
Last Update Date: 04/24/2024
Certification Date: 04/24/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4915 CHARLESTOWN RD
NEW ALBANY IN
47150-9426
US

IV. Provider business mailing address

10809 ELK RUN TRL
SELLERSBURG IN
47172-8642
US

V. Phone/Fax

Practice location:
  • Phone: 812-945-5221
  • Fax:
Mailing address:
  • Phone: 812-581-0513
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number1143729
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: