Provider Demographics
NPI:1235483561
Name:ARNOULD, DEANNA JOY (FNP-BC)
Entity Type:Individual
Prefix:
First Name:DEANNA
Middle Name:JOY
Last Name:ARNOULD
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 5450
Mailing Address - Street 2:
Mailing Address - City:CAROL STREAM
Mailing Address - State:IL
Mailing Address - Zip Code:60197-5450
Mailing Address - Country:US
Mailing Address - Phone:616-954-0600
Mailing Address - Fax:616-954-1675
Practice Address - Street 1:3230 EAGLE PARK DR NE STE 101
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49525-7047
Practice Address - Country:US
Practice Address - Phone:616-954-0600
Practice Address - Fax:616-954-1675
Is Sole Proprietor?:No
Enumeration Date:2012-11-08
Last Update Date:2024-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704239450363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily