Provider Demographics
NPI:1407193485
Name:ARNOLD, HEIDI (PA-C, MMS)
Entity Type:Individual
Prefix:
First Name:HEIDI
Middle Name:
Last Name:ARNOLD
Suffix:
Gender:F
Credentials:PA-C, MMS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1648 ELLIS ST STE 301
Mailing Address - Street 2:
Mailing Address - City:BOZEMAN
Mailing Address - State:MT
Mailing Address - Zip Code:59715-8811
Mailing Address - Country:US
Mailing Address - Phone:406-556-9798
Mailing Address - Fax:406-556-9795
Practice Address - Street 1:1648 ELLIS ST STE 301
Practice Address - Street 2:
Practice Address - City:BOZEMAN
Practice Address - State:MT
Practice Address - Zip Code:59715
Practice Address - Country:US
Practice Address - Phone:406-556-9798
Practice Address - Fax:406-556-9795
Is Sole Proprietor?:No
Enumeration Date:2013-01-10
Last Update Date:2018-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT20541363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant