Provider Demographics
NPI:1477512705
Name:ARNOLD, JEFFREY CHARLES (FNP)
Entity Type:Individual
Prefix:
First Name:JEFFREY
Middle Name:CHARLES
Last Name:ARNOLD
Suffix:
Gender:M
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1514 JEFFERSON HWY
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70121-2429
Mailing Address - Country:US
Mailing Address - Phone:504-842-4000
Mailing Address - Fax:
Practice Address - Street 1:712 WESTBANK EXPY
Practice Address - Street 2:
Practice Address - City:WESTWEGO
Practice Address - State:LA
Practice Address - Zip Code:70094-4400
Practice Address - Country:US
Practice Address - Phone:504-340-7744
Practice Address - Fax:504-348-3935
Is Sole Proprietor?:No
Enumeration Date:2006-03-23
Last Update Date:2017-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA093938363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1173339Medicaid
LA4C898Medicare ID - Type Unspecified
LA1173339Medicaid