Healthcare Provider Details

I. General information

NPI: 1841272119
Provider Name (Legal Business Name): MARY ANITA ARNOLD ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/14/2005
Last Update Date: 02/22/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1025 GRAND AVE
BEATTYVILLE KY
41311-0204
US

IV. Provider business mailing address

PO BOX 636493
CINCINNATI OH
45263-6493
US

V. Phone/Fax

Practice location:
  • Phone: 606-464-8806
  • Fax: 606-464-9453
Mailing address:
  • Phone: 513-981-5098
  • Fax: 513-981-5015

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WC1500X
TaxonomyCommunity Health Registered Nurse
License Number1018525
License Number StateKY
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number3000187
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: