Provider Demographics
NPI:1073244091
Name:ARNOLD, SHELBY (NP)
Entity Type:Individual
Prefix:
First Name:SHELBY
Middle Name:
Last Name:ARNOLD
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1540 LAKE LANSING RD STE G6
Mailing Address - Street 2:
Mailing Address - City:LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48912-3757
Mailing Address - Country:US
Mailing Address - Phone:517-482-7246
Mailing Address - Fax:517-484-7377
Practice Address - Street 1:1540 LAKE LANSING RD STE G6
Practice Address - Street 2:
Practice Address - City:LANSING
Practice Address - State:MI
Practice Address - Zip Code:48912-3757
Practice Address - Country:US
Practice Address - Phone:517-482-7246
Practice Address - Fax:517-484-7377
Is Sole Proprietor?:No
Enumeration Date:2022-06-21
Last Update Date:2022-06-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI4704319461363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner