Provider Demographics
NPI:1437141421
Name:ARNOLD, SHARON K (ARNP C)
Entity Type:Individual
Prefix:MRS
First Name:SHARON
Middle Name:K
Last Name:ARNOLD
Suffix:
Gender:F
Credentials:ARNP C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1910 DEE AVE
Mailing Address - Street 2:
Mailing Address - City:WINFIELD
Mailing Address - State:KS
Mailing Address - Zip Code:67156-1510
Mailing Address - Country:US
Mailing Address - Phone:620-876-5863
Mailing Address - Fax:620-876-5865
Practice Address - Street 1:204 N MAIN
Practice Address - Street 2:
Practice Address - City:DEXTER
Practice Address - State:KS
Practice Address - Zip Code:67038
Practice Address - Country:US
Practice Address - Phone:620-876-5863
Practice Address - Fax:620-876-5865
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS44346363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS1000050911Medicaid