Healthcare Provider Details

I. General information

NPI: 1043283203
Provider Name (Legal Business Name): JENNIFER J ARNHOLD MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/08/2006
Last Update Date: 03/07/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4 DEERWOOD AVE NW
WADENA MN
56482-1253
US

IV. Provider business mailing address

4 DEERWOOD AVE NW
WADENA MN
56482-1253
US

V. Phone/Fax

Practice location:
  • Phone: 218-631-1360
  • Fax:
Mailing address:
  • Phone: 218-631-1360
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number47168
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: