Provider Demographics
NPI:1083005839
Name:ARNOLD, CAROL (RN)
Entity Type:Individual
Prefix:
First Name:CAROL
Middle Name:
Last Name:ARNOLD
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8378 CREEK ST
Mailing Address - Street 2:
Mailing Address - City:JONESBORO
Mailing Address - State:GA
Mailing Address - Zip Code:30236-3923
Mailing Address - Country:US
Mailing Address - Phone:678-610-7259
Mailing Address - Fax:
Practice Address - Street 1:1117 BATTLECREEK RD
Practice Address - Street 2:
Practice Address - City:JONESBORO
Practice Address - State:GA
Practice Address - Zip Code:30236-2407
Practice Address - Country:US
Practice Address - Phone:678-610-7259
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-02-16
Last Update Date:2015-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN101310171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator