Healthcare Provider Details

I. General information

NPI: 1801446794
Provider Name (Legal Business Name): CHERYLL ARNOLD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/12/2019
Last Update Date: 09/12/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2909 MONUMENT DR NW
ALBUQUERQUE NM
87120-6529
US

IV. Provider business mailing address

2300 DIAMOND MESA TRL SW APT 7804
ALBUQUERQUE NM
87121-3763
US

V. Phone/Fax

Practice location:
  • Phone: 505-235-0423
  • Fax:
Mailing address:
  • Phone: 505-235-0423
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3747A0650X
TaxonomyAttendant Care Provider
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: