Healthcare Provider Details
I. General information
NPI: 1265262026
Provider Name (Legal Business Name): TIANNA MARIE ARNOLD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 08/06/2024
Last Update Date: 08/06/2024
Certification Date: 08/06/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1433 N WATER ST STE 400
MILWAUKEE WI
53202-2603
US
IV. Provider business mailing address
1433 N WATER ST STE 400
MILWAUKEE WI
53202-2603
US
V. Phone/Fax
- Phone: 414-433-3346
- Fax: 800-451-4058
- Phone: 414-433-3346
- Fax: 800-451-4058
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 246RP1900X |
| Taxonomy | Phlebotomy Technician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: