Provider Demographics
NPI:1609194976
Name:ARNOLD, MEGAN E (ARNP)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:E
Last Name:ARNOLD
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:MEGAN
Other - Middle Name:
Other - Last Name:MCKINLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ARNP
Mailing Address - Street 1:PO BOX 776879
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60677-6879
Mailing Address - Country:US
Mailing Address - Phone:502-588-9490
Mailing Address - Fax:502-272-5116
Practice Address - Street 1:13050 MAGISTERIAL DR STE 100
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40223-5181
Practice Address - Country:US
Practice Address - Phone:502-694-5450
Practice Address - Fax:502-385-6665
Is Sole Proprietor?:No
Enumeration Date:2010-05-12
Last Update Date:2023-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN28180958363LF0000X
KY3007180363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100189210Medicaid
IN200992340Medicaid
KY7100189210Medicaid