Healthcare Provider Details

I. General information

NPI: 1669382388
Provider Name (Legal Business Name): KAIDAN ARNOLD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/08/2026
Last Update Date: 09/08/2026
Certification Date: 09/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2 COUNTY ROAD 6196
KIRTLAND NM
87417-9333
US

IV. Provider business mailing address

2 COUNTY ROAD 6196
KIRTLAND NM
87417-9333
US

V. Phone/Fax

Practice location:
  • Phone: 505-947-6144
  • Fax:
Mailing address:
  • Phone: 505-947-6144
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number521147806
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: