MEDICARE: KATHLEEN CECILIA ARNOLD A.N.P.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LA2200X	Adult Health Nurse Practitioner	R854239	MS
2	363LA2100X	Acute Care Nurse Practitioner	R854239	MS

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1134107139
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATHLEEN CECILIA ARNOLD A.N.P.

Provider Business Mailing Address
First Line	:	1278 OCEAN SPRINGS RD
Second Line	:
City	:	OCEAN SPRINGS
State	:	MS
Zip	:	39564-3409
Country	:	US
Telephone Number	:	228-875-3606
Fax Number	:	228-875-3687

Provider Business Practice Location Address
First Line	:	1278 OCEAN SPRINGS RD
Second Line	:
City	:	OCEAN SPRINGS
State	:	MS
Zip	:	39564-3409
Country	:	US
Telephone Number	:	228-875-3606
Fax Number	:	228-875-3687

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/09/2006
Last Update Date	:	08/05/2020

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