Provider Demographics
NPI:1417469370
Name:ARNOLD, TERRY LEE II (MSN, RN)
Entity Type:Individual
Prefix:MR
First Name:TERRY
Middle Name:LEE
Last Name:ARNOLD
Suffix:II
Gender:M
Credentials:MSN, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:250 TIMBER LN
Mailing Address - Street 2:
Mailing Address - City:BATTLE CREEK
Mailing Address - State:MI
Mailing Address - Zip Code:49037-1748
Mailing Address - Country:US
Mailing Address - Phone:269-223-2342
Mailing Address - Fax:
Practice Address - Street 1:1040 N 10TH ST STE 100
Practice Address - Street 2:
Practice Address - City:KALAMAZOO
Practice Address - State:MI
Practice Address - Zip Code:49009-6150
Practice Address - Country:US
Practice Address - Phone:269-353-4366
Practice Address - Fax:269-353-4793
Is Sole Proprietor?:No
Enumeration Date:2017-11-01
Last Update Date:2017-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704230220163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4704230220OtherREGISTERED NURSE LICENSE