=====================================================
General NPI Number Information
=====================================================
NPI Number | 1023128980
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ARLENE M ZWALD ARNP
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/30/2006
-----------------------------------------------------
Last Update Date | 09/17/2008
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1009 N GEORGETOWN ST
-----------------------------------------------------
City | ROUND ROCK
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 78664-3289
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 512-244-8480
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 24912 SINGLETON BEND EAST RD
-----------------------------------------------------
City | MARBLE FALLS
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 78654-3622
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 509-293-3794
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LP0808X
-----------------------------------------------------
Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
-----------------------------------------------------
License Number | AP30007452
-----------------------------------------------------
License Number State | WA
-----------------------------------------------------