Provider Demographics
NPI:1437151511
Name:ARNOLD, MIRIAM (CRNA)
Entity Type:Individual
Prefix:
First Name:MIRIAM
Middle Name:
Last Name:ARNOLD
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14535 118TH ST N
Mailing Address - Street 2:
Mailing Address - City:STILLWATER
Mailing Address - State:MN
Mailing Address - Zip Code:55082-8903
Mailing Address - Country:US
Mailing Address - Phone:651-439-8430
Mailing Address - Fax:
Practice Address - Street 1:1175 NININGER RD
Practice Address - Street 2:
Practice Address - City:HASTINGS
Practice Address - State:MN
Practice Address - Zip Code:55033-1056
Practice Address - Country:US
Practice Address - Phone:651-480-4299
Practice Address - Fax:651-480-4411
Is Sole Proprietor?:No
Enumeration Date:2005-08-10
Last Update Date:2016-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNR079328-1372500000X
MNCRNA 1386367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No372500000XNursing Service Related ProvidersChore Provider