Healthcare Provider Details

I. General information

NPI: 1437971652
Provider Name (Legal Business Name): WILLIAM CHAD ARNOLD RN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/29/2024
Last Update Date: 10/29/2024
Certification Date: 10/29/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1300 CAMINO SIERRA VIS
SANTA FE NM
87505-1007
US

IV. Provider business mailing address

1300 CAMINO SIERRA VIS
SANTA FE NM
87505-1007
US

V. Phone/Fax

Practice location:
  • Phone: 505-467-2504
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WS0200X
TaxonomySchool Registered Nurse
License NumberR67616
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: