MEDICARE: MARY ANITA ARNOLD ARNP

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	163WC1500X	Community Health Registered Nurse	1018525	KY
2	363LF0000X	Family Nurse Practitioner	3000187	KY

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	:	1841272119
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARY ANITA ARNOLD ARNP

Provider Business Mailing Address
First Line	:	PO BOX 636493
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45263-6493
Country	:	US
Telephone Number	:	513-981-5098
Fax Number	:	513-981-5015

Provider Business Practice Location Address
First Line	:	1025 GRAND AVE
Second Line	:
City	:	BEATTYVILLE
State	:	KY
Zip	:	41311-0204
Country	:	US
Telephone Number	:	606-464-8806
Fax Number	:	606-464-9453

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

Provider Enumeration Date	:	11/14/2005
Last Update Date	:	02/22/2013

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