Provider Demographics
NPI:1467842344
Name:ARNOLD, MARENA A (NP)
Entity Type:Individual
Prefix:
First Name:MARENA
Middle Name:A
Last Name:ARNOLD
Suffix:
Gender:F
Credentials:NP
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Mailing Address - Street 1:6920 POINTE INVERNESS WAY STE 200
Mailing Address - Street 2:MEDPARTNERS, ATTN: BARB COPELAND
Mailing Address - City:FORT WAYNE
Mailing Address - State:IN
Mailing Address - Zip Code:46804-7934
Mailing Address - Country:US
Mailing Address - Phone:260-479-3514
Mailing Address - Fax:260-479-3520
Practice Address - Street 1:7910 W JEFFERSON BLVD
Practice Address - Street 2:SUITE 120
Practice Address - City:FORT WAYNE
Practice Address - State:IN
Practice Address - Zip Code:46804-4159
Practice Address - Country:US
Practice Address - Phone:260-435-7612
Practice Address - Fax:260-435-7672
Is Sole Proprietor?:No
Enumeration Date:2015-01-29
Last Update Date:2020-09-11
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Provider Licenses
StateLicense IDTaxonomies
IN71005456A363LG0600X, 363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN201299250Medicaid
IN260690057Medicare PIN