Provider Demographics
NPI:1275591695
Name:ARNOLD, AMY K (ARNP)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:K
Last Name:ARNOLD
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:AMY
Other - Middle Name:K
Other - Last Name:NELSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ARNP
Mailing Address - Street 1:2901 W. BELTLINE HWY.
Mailing Address - Street 2:SUITE 120
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53713-4226
Mailing Address - Country:US
Mailing Address - Phone:608-443-5603
Mailing Address - Fax:608-441-1981
Practice Address - Street 1:2202 SOUTH PARK ST.
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53713-1916
Practice Address - Country:US
Practice Address - Phone:608-443-2676
Practice Address - Fax:608-443-5534
Is Sole Proprietor?:No
Enumeration Date:2006-05-03
Last Update Date:2012-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9218878363L00000X
WI3446-33363L00000X
WI158288-30363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI36091100Medicaid
FL307370000Medicaid