Provider Demographics
NPI:1629137765
Name:ARNOLD, THOMAS MICHEAL JR (RN)
Entity Type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:MICHEAL
Last Name:ARNOLD
Suffix:JR
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6256 RED HAW LN
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46236-2935
Mailing Address - Country:US
Mailing Address - Phone:317-523-3879
Mailing Address - Fax:
Practice Address - Street 1:6256 RED HAW LN
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46236-2935
Practice Address - Country:US
Practice Address - Phone:317-523-3879
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN28161252A163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse