Provider Demographics
NPI:1497709547
Name:ARNOLD, ANGELA KAY (APRN)
Entity Type:Individual
Prefix:MISS
First Name:ANGELA
Middle Name:KAY
Last Name:ARNOLD
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 950122
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40295-0122
Mailing Address - Country:US
Mailing Address - Phone:502-893-7462
Mailing Address - Fax:502-212-7551
Practice Address - Street 1:4003 KRESGE WAY
Practice Address - Street 2:SUITE 410
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40207-4652
Practice Address - Country:US
Practice Address - Phone:502-893-7462
Practice Address - Fax:502-212-7551
Is Sole Proprietor?:No
Enumeration Date:2006-05-22
Last Update Date:2014-08-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KY1092664163W00000X
KY3003078363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY000000475614OtherANTHEM
S96490Medicare UPIN
KY0614105Medicare ID - Type Unspecified