Provider Demographics
NPI:1265485882
Name:ARNOLD, JEANNE MARIE (DPM)
Entity Type:Individual
Prefix:
First Name:JEANNE
Middle Name:MARIE
Last Name:ARNOLD
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:204 E SUPERIOR ST
Mailing Address - Street 2:STE 7
Mailing Address - City:SANDPOINT
Mailing Address - State:ID
Mailing Address - Zip Code:83864-1275
Mailing Address - Country:US
Mailing Address - Phone:208-265-4321
Mailing Address - Fax:208-265-4973
Practice Address - Street 1:204 E SUPERIOR ST
Practice Address - Street 2:STE 7
Practice Address - City:SANDPOINT
Practice Address - State:ID
Practice Address - Zip Code:83864-1275
Practice Address - Country:US
Practice Address - Phone:208-265-4321
Practice Address - Fax:208-265-4973
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-17
Last Update Date:2022-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDP112213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ID002657700Medicaid
ID002657700Medicaid
1350572Medicare ID - Type Unspecified
1350571Medicare ID - Type Unspecified