Healthcare Provider Details

I. General information

NPI: 1154042745
Provider Name (Legal Business Name): ELIZABETH ARNOLD RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/12/2022
Last Update Date: 03/20/2026
Certification Date: 03/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1220 N ELM PL
BROKEN ARROW OK
74012-1616
US

IV. Provider business mailing address

1220 N ELM PL
BROKEN ARROW OK
74012-1616
US

V. Phone/Fax

Practice location:
  • Phone: 918-237-9515
  • Fax:
Mailing address:
  • Phone: 918-258-1995
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number205447
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: