Healthcare Provider Details

I. General information

NPI: 1639092794
Provider Name (Legal Business Name): AMBER CARITA ARZOLA FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/04/2026
Last Update Date: 08/04/2026
Certification Date: 07/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1245 E IRELAND RD UNIT B
SOUTH BEND IN
46614-3448
US

IV. Provider business mailing address

1245 E IRELAND RD UNIT B
SOUTH BEND IN
46614-3448
US

V. Phone/Fax

Practice location:
  • Phone: 574-312-7022
  • Fax:
Mailing address:
  • Phone: 574-312-7022
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number71018459A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: