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General NPI Number Information
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NPI Number | 1740619899
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Entity Type | Individual
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Provider Name | GABRIELLE DANIEL ARNDT PA-C
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Gender | Female
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Dates
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Enumeration Date | 11/08/2013
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Last Update Date | 11/30/2015
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Provider Practice Location Address
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Address Line | 205 S PARK LN SUITE 210
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City | ALTUS
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State | OK
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Zip | 73521-5755
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Country | US
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Telephone | 580-379-6650
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Fax | 580-379-6659
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Provider Business Mailing Address
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Address Line | 901 STEPHANIE LN
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City | ALTUS
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State | OK
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Zip | 73521
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 2014
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License Number State | SC
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 2544
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License Number State | OK
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