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NPI Code Detail

MEDICARE: MISS KATIE LANE ARNOLD MAE, ATC, LAT

MEDICARE: MISS KATIE LANE ARNOLD MAE, ATC, LAT
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
12255A2300XAthletic Trainer1152TN

General Provider Information

NPI Number : 1942632021
Entity Type Code : Individual
Provider Name (Legal Business Name) : MISS KATIE LANE ARNOLD MAE, ATC, LAT
Provider Business Mailing Address
First Line : 374 OWL DR
Second Line :
City : LEBANON
State : TN
Zip : 37087-7620
Country : US
Telephone Number : 865-617-3252
Fax Number : 615-547-1309
Provider Business Practice Location Address
First Line : 1 CUMBERLAND SQ
Second Line :
City : LEBANON
State : TN
Zip : 37087-3408
Country : US
Telephone Number : 615-547-1334
Fax Number : 615-547-1309
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/31/2013
Last Update Date : 07/31/2013

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Directions to “ MISS KATIE LANE ARNOLD MAE, ATC, LAT” Practice Location

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