MEDICARE: RAQUEL ARNOLD

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	376K00000X	Nurse's Aide	A654730139151	MI

General Provider Information

NPI Number	:	1629726674
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RAQUEL ARNOLD

Provider Business Mailing Address
First Line	:	4850 GRAYTON ST
Second Line	:
City	:	DETROIT
State	:	MI
Zip	:	48224-2364
Country	:	US
Telephone Number	:	313-685-6953
Fax Number	:

Provider Business Practice Location Address
First Line	:	4850 GRAYTON ST
Second Line	:
City	:	DETROIT
State	:	MI
Zip	:	48224-2364
Country	:	US
Telephone Number	:	313-685-6953
Fax Number	:

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

Provider Enumeration Date	:	03/17/2022
Last Update Date	:	03/17/2022

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Directions to “ RAQUEL ARNOLD ” Practice Location

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