Provider Demographics
NPI:1164871141
Name:ARNOLD, ASHELY
Entity Type:Individual
Prefix:
First Name:ASHELY
Middle Name:
Last Name:ARNOLD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:934 SW 35TH ST
Mailing Address - Street 2:APT 214
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78237-3378
Mailing Address - Country:US
Mailing Address - Phone:210-504-0621
Mailing Address - Fax:
Practice Address - Street 1:934 SW 35TH ST
Practice Address - Street 2:APT 214
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78237-3378
Practice Address - Country:US
Practice Address - Phone:210-504-0621
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-09
Last Update Date:2016-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX507799236Medicaid