Provider Demographics
NPI:1326775024
Name:PRACTIHEALTH, LLC
Entity Type:Organization
Organization Name:PRACTIHEALTH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:ANDREIA
Authorized Official - Middle Name:L
Authorized Official - Last Name:ARNOLD
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:937-789-3801
Mailing Address - Street 1:18185 W EAST WIND AVE
Mailing Address - Street 2:
Mailing Address - City:GOODYEAR
Mailing Address - State:AZ
Mailing Address - Zip Code:85338-5061
Mailing Address - Country:US
Mailing Address - Phone:937-789-3801
Mailing Address - Fax:
Practice Address - Street 1:18185 W EAST WIND AVE
Practice Address - Street 2:
Practice Address - City:GOODYEAR
Practice Address - State:AZ
Practice Address - Zip Code:85338-5061
Practice Address - Country:US
Practice Address - Phone:937-789-3801
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-03
Last Update Date:2022-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain MedicineGroup - Single Specialty