Provider Demographics
NPI:1235369927
Name:ARNOLD, BROOK N (MD)
Entity Type:Individual
Prefix:DR
First Name:BROOK
Middle Name:N
Last Name:ARNOLD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:BROOK
Other - Middle Name:L
Other - Last Name:NIGHTWALKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1236 E ELIZABETH ST
Mailing Address - Street 2:SUITE 1
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80524-4000
Mailing Address - Country:US
Mailing Address - Phone:970-224-2985
Mailing Address - Fax:
Practice Address - Street 1:1236 E ELIZABETH ST
Practice Address - Street 2:SUITE 1
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80524-4000
Practice Address - Country:US
Practice Address - Phone:970-224-2985
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-07-16
Last Update Date:2014-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODR.0052352207L00000X, 207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO75571382Medicaid
WY136379400Medicaid
NE84143963013Medicaid
COP01284504OtherRR MEDICARE
CO312352YTMFMedicare PIN