Healthcare Provider Details

I. General information

NPI: 1275591695
Provider Name (Legal Business Name): AMY K ARNOLD ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: AMY K NELSON ARNP

II. Dates (important events)

Enumeration Date: 05/03/2006
Last Update Date: 04/10/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2202 SOUTH PARK ST.
MADISON WI
53713-1916
US

IV. Provider business mailing address

2901 W. BELTLINE HWY. SUITE 120
MADISON WI
53713-4226
US

V. Phone/Fax

Practice location:
  • Phone: 608-443-2676
  • Fax: 608-443-5534
Mailing address:
  • Phone: 608-443-5603
  • Fax: 608-441-1981

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberARNP9218878
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number3446-33
License Number StateWI
# 3
Primary TaxonomyN
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number158288-30
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: